FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3792451 · Received December 31, 2013

Report

Report Number
1314492-2013-23932
Event Type
Malfunction
Date Received
December 31, 2013
Date of Event
December 1, 2013
Report Date
December 4, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS EVALUATED BY BAXTER. THE REPORTED SYMPTOM WAS CONFIRMED AND REPRODUCED. THE UNIT WAS RECEIVED INOPERABLE DUE TO CONSTANT "DOOR NOT FULLY LATCHED" MESSAGES CORRESPONDING WITH THE REPORTED SYMPTOM CAUSED BY A LOOSE LINK SCREW (UPPER). THE SCREW WAS ADJUSTED DURING EVALUATION WITH THE DOOR PERFORMING AS EXPECTED. THE SCREWS WERE REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP DISPLAYED DOOR NOT LATCHED MESSAGES. IT WAS DETERMINED THAT THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
683276 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1