FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3780040 · Received January 6, 2014

Report

Report Number
1314492-2014-00861
Event Type
Malfunction
Date Received
January 6, 2014
Date of Event
December 1, 2013
Report Date
December 9, 2013
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVAL WAS PERFORMED. THE EVAL COULD NOT REPRODUCE THE REPORTED SYMPTOM. REVIEW OF THE HISTORY LOG CONFIRMED THE REPORTED SYMPTOM, THE EVAL FOUND THAT THE UPPER AND LOWER AUXILIARY ASSEMBLIES WERE FAILING, WHICH ARE KNOWN CONTRIBUTORS TO SYSTEM ERROR 322 ALARMS. THE UPPER AND LOWER AUXILIARY ASSEMBLIES WERE REPLACED. 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.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP HAS A SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THEE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
8090 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1