FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3597798 · Received September 11, 2013

Report

Report Number
1314492-2013-07013
Event Type
Malfunction
Date Received
September 11, 2013
Date of Event
August 1, 2013
Report Date
August 15, 2013
Manufacturer
BAXTER HEALTHCARE CORP.
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED AND EVALUATED BY BAXTER. UNIT WAS TESTED FOR 24 HOURS WITH NO OCCURRENCE OF EC (B)(4). REVIEW OF THE HISTORY LOG CONFIRMS THE EC 322 REPORTED SYMPTOM. EVALUATION WAS UNABLE TO DETERMINE THE CAUSE. EVALUATION OF KNOWN CONTRIBUTORS TO EC 322 HAS LED TO THE DETERMINATION THAT THE UPPER AND LOWER AUXILIARY WERE THE FAILING COMPONENTS AND WERE REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP EXPERIENCED SYSTEM ERROR 322 - LINK SWITCH ERROR (LOW) ALARMS. THERE WAS ALSO NO PT INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
457513 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP. 35700

Patients

Seq Age Sex Outcome Treatment
1