FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3240910 · Received July 17, 2013

Report

Report Number
1314492-2013-01355
Event Type
Malfunction
Date Received
July 17, 2013
Date of Event
June 1, 2013
Report Date
June 18, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVAL WAS PERFORMED. THE EVAL FOUND THE UPPER LATCH SWITCH BRACKET SCREWS TO BE LOOSE ALLOWING THE UPPER LATCH SWITCH TO MOVE IN AND OUT FROM THE UPPER DOOR LATCH. THE LOOSE NYLON SCREWS WILL TRIGGER AN INTERMITTENT OPEN/CLOSED SWITCH CONNECTION CAUSING THE EC 322. THE UPPER AUXILIARY ASSEMBLY WILL BE REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP HAS A SYSTEM ERROR 322. THE CUSTOMER STATED THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
332929 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1