FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3780057 · Received January 6, 2014

Report

Report Number
1314492-2014-00848
Event Type
Malfunction
Date Received
January 6, 2014
Date of Event
December 1, 2013
Report Date
December 31, 2013
Manufacturer
BAXTER HEALTHCARE CORP.
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE HAS BEEN RETURNED TO BAXTER FOR EVAL. THE INVESTIGATION IS NOT COMPLETE AT THIS TIME. A SUPPLEMENTAL REPORT WILL BE SUBMITTED ONCE THE INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE SPECTRUM PUMP DISPLAYED SYSTEM ERROR 322 ALARMS. THE DEVICE WAS FROM THE NICU DEPARTMENT. THERE WAS NO PT INJURY. NO FURTHER INFO WAS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
8120 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP. 35700

Patients

Seq Age Sex Outcome Treatment
1