FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3801753 · Received January 8, 2014

Report

Report Number
1314492-2014-01369
Event Type
Malfunction
Date Received
January 8, 2014
Date of Event
December 1, 2013
Report Date
December 11, 2013
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP FALSELY ALARMED DOWNSTREAM OCCLUSION. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
12265 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1