FDA Adverse Event Malfunction Summary report: N

80FRN

MDR report key: 3822794 · Received February 7, 2014

Report

Report Number
9615050-2014-00992
Event Type
Malfunction
Date Received
February 7, 2014
Date of Event
January 9, 2014
Report Date
January 9, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K060806
Removal / Correction Number
Z-1159-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND AT POWER UP THE DEVICE ALARMED FOR 11/004 (LESS THAN 2.0 VOLTS ON LITHIUM BATTERY) SERVICE CODE ALARM. 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 PRIOR TO PT USE, THE DEVICE ALARMED WITH A 11/004 (LESS THAN 2.0 VOLTS ON LITHIUM BATTERY) SERVICE ALARM CODE. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS OR DELAYS IN CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. DURING TESTING AT THE USER FACILITY, THE DEVICE WOULD NOT RESPOND WHEN PRESSED. NO ADD'L INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
80746 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA