FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3240938 · Received July 17, 2013

Report

Report Number
1314492-2013-01360
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
AZ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RECEIVED AND EVALUATED BY BAXTER. EVAL CONFIRMED THAT REPORTED SYMPTOM THROUGH THE DEVICE HISTORY LOG BUT WAS UNABLE TO REPRODUCE UNDER TEST. 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. THE UPPER AND LOWER AUX WILL BE REPLACED AS THEY ARE KNOWN TO CONTRIBUTE TO SYSTEM ERROR 322.

Description of Event or Problem · 1

IT WAS REPORTED THAT A DEVICE ALARMED FOR ERROR CODE 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
332081 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1