FDA Adverse Event Malfunction Summary report: N

SYMBIQ SINGLE CHANNE

MDR report key: 3822780 · Received February 7, 2014

Report

Report Number
9615050-2014-00996
Event Type
Malfunction
Date Received
February 7, 2014
Date of Event
January 7, 2014
Report Date
January 9, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K110901
Removal / Correction Number
Z-0069-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND THAT THE DEVICE TOUCHSCREEN DID NOT RESPOND AND WOULD NOT CALIBRATE. THE DEVICE HAS BEEN IDENTIFIED AS PART OF A PRODUCT RECALL. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING PREVENTATIVE MAINTENANCE TESTING AT THE USER FACILITY, THE DEVICE TOUCHSCREEN WOULD NOT CALIBRATE IN THE SERVICE MODE. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS OR DELAYS IN CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. NO ADD'L INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
80741 SYMBIQ SINGLE CHANNE 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA