FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3260012 · Received August 1, 2013

Report

Report Number
1416980-2013-20369
Event Type
Malfunction
Date Received
August 1, 2013
Date of Event
July 8, 2013
Report Date
July 8, 2013
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
PMA / PMN Number
K915523
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VE
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. THIS IS AN ANCILLARY SERVICE EVENT OPENED DURING INVESTIGATION OF (B)(4). THE ROOT CAUSE OF THE F-66 ALARM WAS DETERMINED TO BE A CRACKED CENTRAL PROCESSING UNIT (CPU) BOARD. TO CORRECT THE CONDITION, THE CPU BOARD WAS REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

DURING ON-SITE SERVICE BY A FIELD SERVICE TECHNICIAN, A FLO-GARD INFUSION PUMP EXPERIENCED THE F-66 ALARM. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
359474 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1