FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3221599 · Received July 3, 2013

Report

Report Number
1314492-2013-00978
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
MI, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. A SYSTEM ERROR 322 ALARM WAS CONFIRMED THROUGH REVIEW OF THE DEVICE'S HISTORY LOG, AS WELL AS REPRODUCED DURING THE EVAL. THE DEVICE WAS RUN FOR (B)(4) HRS BEFORE EXPERIENCING A SYSTEM ERROR 322 ALARM. THIS ERROR WAS CAUSED BY A FAILED COMPONENT ON THE INPUT/OUTPUT PRINTED CIRCUIT BOARD (I/O PCB). THE I/O PCB WAS REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP WAS ALARMING CONSTANTLY FOR SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
303514 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1