FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3221581 · Received July 3, 2013

Report

Report Number
1314492-2013-00972
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
OR, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RECEIVED AND EVALUATED BY BAXTER. THE REPORTED "FAILED DOWNSTREAM OCCLUSION SENSOR PREVENTATIVE MAINTENANCE TEST" WAS UNABLE TO BE CONFIRMED. THE UNIT PASSED DOWNSTREAM PRESSURE TESTING IN ACCORDANCE WITH THE PREVENTATIVE MAINTENANCE PROCEDURE, AS WELL AS ADDITIONAL OCCLUSION TESTING.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP FAILED THE DOWNSTREAM OCCLUSION SENSOR PREVENTATIVE MAINTENANCE TEST. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
303463 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP. 35700

Patients

Seq Age Sex Outcome Treatment
1