FDA Adverse Event
Malfunction
Summary report: N
FLOGUARD
MDR report key: 3243807
·
Received July 23, 2013
Report
- Report Number
- 1416980-2013-19531
- Event Type
- Malfunction
- Date Received
- July 23, 2013
- Date of Event
- June 17, 2013
- Report Date
- June 27, 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 REVEALED THAT THE REPORTED "MALFUNCTION" WAS AN F_38 ALARM. THE CAUSE OF THE ALARM WAS DETERMINED TO BE DEFECTIVE FORCE SENSING RESISTORS (FSRS). IN ORDER TO ADDRESS THIS ISSUE, THE FSRS WERE REPLACED. THE DEVICE WAS RESTORED TO GOOD WORKING CONDITION AND RETURNED TO THE CUSTOMER. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Description of Event or Problem · 1
IT WAS REPORTED THAT A FLOGARD INFUSION PUMP MALFUNCTIONED. THE TYPE OF MALFUNCTION AND WHEN IN THE PROCESS THIS OCCURRED WERE NOT SPECIFIED. THERE WAS NO PATIENT INVOLVEMENT REPORTED. NO ADDITIONAL INFORMATION IS AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 343054 | FLOGUARD | PUMP, INFUSION | FRN | BAXTER HEALTHCARE - SINGAPORE |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |