FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3221539 · Received July 3, 2013

Report

Report Number
1314492-2013-00983
Event Type
Malfunction
Date Received
July 3, 2013
Date of Event
June 1, 2013
Report Date
June 4, 2013
Manufacturer
BAXTER HEALTHCARE CORP.
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED AND EVALUATED BY BAXTER. EVAL FOUND THE LOW READINGS ON THE ULTRASONIC SENSOR CAUSED BY A FAILED UPSTREAM SENSOR. WITH LOW ULTRASONIC READINGS IT WOULD MAKE THE PUMP MORE SENSITIVE TO UPSTREAM OCCLUSION ALARMS. THE UPSTREAM SENSOR WILL BE REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP ALARMS FOR UPSTREAM OCCLUSION WHEN NO OCCLUSION IS PRESENT. THE CUSTOMER ALSO STATED THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
304658 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP. 35700

Patients

Seq Age Sex Outcome Treatment
1