FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3223891 · Received July 2, 2013

Report

Report Number
1314492-2013-00959
Event Type
Malfunction
Date Received
July 2, 2013
Date of Event
June 1, 2013
Report Date
June 3, 2013
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED AND EVALUATED BY BAXTER. THE BAXTER EVAL COULD NOT REPRODUCE THE REPORTED SYMPTOM BUT CONFIRMED THE OCCURRENCE OF SYSTEM ERROR 322 THROUGH HISTORY LOG REVIEW. FURTHER EVAL FOUND THE UPPER LATCH SWITCH TO BECOME INTERMITTENTLY OPEN WHICH COULD CAUSE THE SYSTEM ERROR 322. THE UPPER AUXILIARY FLEX WILL BE REPLACED. SYSTEM ERROR 322 WILL OCCUR WHEN THE PUMP TRANSITIONS FROM THE DOOR OPEN STATE TO THE DOOR CLOSED/SET-LOADED STATE AND THE LOWER LINK SWITCH DOES NOT ACTIVATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP HAS ALARMED SYSTEM ERROR 322 MULTIPLE TIMES. THE CUSTOMER STATED THERE WAS NO PT INJURY AND THE DEVICE WAS BEING USED IN THE CCU.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
300617 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1