FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3230369 · Received July 16, 2013

Report

Report Number
1416980-2013-18703
Event Type
Malfunction
Date Received
July 16, 2013
Date of Event
May 24, 2013
Report Date
June 3, 2013
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915522
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS SERVICED BY A SERVICE TECHNICIAN. FUNCTIONAL TESTING DETERMINED THAT THE UNDETERMINED FAILURE WAS AN F_38 ALARM. THE CAUSE OF THE REPORTED CONDITION WAS DEFECTIVE FORCE SENSING RESISTORS (FSRS). TO ADDRESS THE ISSUE THE FSRS WERE REPLACED. THE DEVICE WAS RESTORED TO A GOOD WORKING CONDITION AND RETURNED TO THE CUSTOMER. IF ANY ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL MDR WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A FLOGARD INFUSION PUMP EXPERIENCED AN UNDETERMINED MALFUNCTION. IT WAS NOT SPECIFIED WHEN IN THE PROCESS THIS OCCURRED. THERE WAS NO PATIENT INVOLVEMENT REPORTED. ADDITIONAL INFORMATION WAS REQUESTED AND IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
329015 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1