FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3191188 · Received June 14, 2013

Report

Report Number
1314492-2013-00787
Event Type
Malfunction
Date Received
June 14, 2013
Date of Event
May 1, 2013
Report Date
May 17, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BAXTER REC'D AND EVALUATED THE DEVICE. THE EVALUATION CONFIRMED THAT THE DEVICE ALARMED FOR AN UPSTREAM OCCLUSION WHEN NO OCCLUSION WAS PRESENT. THIS WAS CAUSED BY THE UPPER SENSOR READING TO BE BELOW SPECIFICATION. THE UPSTREAM PUSHER THICKNESS WAS INCREASED AND THE DEVICE PERFORMED AS EXPECTED. REVIEW OF THE DEVICE HISTORY LOG SHOWS MULTIPLE AIR-IN-LINE ALARMS, HOWEVER NONE COULD BE REPRODUCED DURING THE EVALUATION. FURTHERMORE, THE SPECTRUM OPERATORS MANUAL WARNS THE USER THAT WHEN THE DEVICE ALARMS FOR AIR-IN-LINE, AN UPSTREAM OCCLUSION MAY EXIST.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP ALARMS CONSTANTLY FOR AIR IN LINE. NO PT INJURY WAS REPORTED AND NO ADD'L INFO COULD BE OBTAINED FROM THE CUSTOMER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
272332 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1