BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SPECTRUM INFUSION PUMP

    MDR report key: 3780045 · Received January 6, 2014

    Report

    Report Number
    1314492-2014-00862
    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 EVENT HISTORY LOG CONFIRMED THE REPORTED SYMPTOM. FURTHER INSPECTION OF THE DEVICE FOUND A DISLODGED COMPONENT OF THE I/O PRINTED CIRCUIT BOARD, WHICH IS A KNOWN CONTRIBUTOR TO SYSTEM ERROR 105 ALARMS. THE I/O PRINTED CIRCUIT BOARD WAS REPLACED.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT A PUMP ALARMS SYSTEM ERROR 105. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    8137 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

    Patients

    Seq Age Sex Outcome Treatment
    1