FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3182371 · Received June 21, 2013

Report

Report Number
1416980-2013-16148
Event Type
Malfunction
Date Received
June 21, 2013
Report Date
May 28, 2013
Manufacturer
SHARP CORPORATION OSAKA JAPAN
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS SERVICED AT THE CUSTOMER SITE. THE SAMPLE WAS VISUALLY INSPECTED AND FUNCTIONALLY TESTED. THE REPORTED CONDITION OF AN F-38 ALARM WAS CONFIRMED. THE CAUSE OF THE REPORTED CONDITION WAS DUE TO DAMAGED FORCE SENSING RESISTORS (FSRS). IN ORDER TO CORRECT THE ISSUE THE FSRS WERE REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. IF ANY ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A FOLLOW UP MDR WILL BE SENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT A FLOGARD INFUSION PUMP HAD EXPERIENCED AN F-38 ALARM. THERE WAS NO PATIENT INVOLVEMENT. ADDITIONAL INFORMATION WAS REQUESTED AND IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
283166 FLOGARD PUMP, INFUSION FRN SHARP CORPORATION OSAKA JAPAN

Patients

Seq Age Sex Outcome Treatment
1