FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3780213 · Received January 3, 2014

Report

Report Number
1314492-2014-00499
Event Type
Malfunction
Date Received
January 3, 2014
Date of Event
December 1, 2013
Report Date
December 6, 2013
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BAXTER RECEIVED THE DEVICE, BUT THE EVAL IS STILL IN PROGRESS. WHEN THE EVAL IS COMPLETE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP FALSELY ALARMED AIR IN LINE. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
5161 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1