BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SPECTRUM INFUSION PUMP

    MDR report key: 3240943 · Received July 17, 2013

    Report

    Report Number
    1314492-2013-01364
    Event Type
    Malfunction
    Date Received
    July 17, 2013
    Date of Event
    June 18, 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
    NY, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE IN QUESTION. THIS COMPLAINT WAS DISCOVERED DURING THE INVESTIGATION OF (B)(4). THE UPSTREAM OCCLUSION ALARMS WERE CONFIRMED THROUGH THE EVENT HISTORY LOG REVIEWS. THE CAUSE WAS UNDETERMINED. IF ANY ADD'L INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT. THE UPSTREAM SENSOR WAS REPLACED.

    Description of Event or Problem · 1

    UPSTREAM OCCLUSION ALARMS WERE FOUND IN THE EVENT HISTORY LOG DURING EVAL. IT WAS REPORTED THERE WAS NO PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    332934 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

    Patients

    Seq Age Sex Outcome Treatment
    1