FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3182492 · Received June 11, 2013

Report

Report Number
1314492-2013-00745
Event Type
Malfunction
Date Received
June 11, 2013
Date of Event
May 1, 2013
Report Date
May 13, 2013
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE EVALUATION COULD NOT CONFIRM THE REPORTED SYMPTOM OF "UPSTREAM OCCLUSION TEST IS FAILING, DOES NOT ALARM." UPSTREAM OCCLUSION TEST WAS PERFORMED PER SPECTRUM SERVICE MANUAL (PM INSPECTION) WITH UNIT PASSING. THE UNIT ALSO PASSED ADDITIONAL UPSTREAM OCCLUSION TESTS.

Description of Event or Problem · 1

IT WAS REPORTED THAT A DEVICE WAS UNABLE TO DETECT AN UPSTREAM OCCLUSION DURING TESTING. THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
264744 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1