FDA Adverse Event
Malfunction
Summary report: N
SPECTRUM INFUSION PUMP
MDR report key: 3853253
·
Received January 23, 2014
Report
- Report Number
- 1314492-2014-04182
- Event Type
- Malfunction
- Date Received
- January 23, 2014
- Date of Event
- December 1, 2013
- Report Date
- December 27, 2013
- Manufacturer
- BAXTER HEALTHCARE CORPORATION
- Product Code
- FRN
- PMA / PMN Number
- K042121
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- BIOMEDICAL ENGINEER
Narratives
Additional Manufacturer Narrative · 1
(B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE DEVICE WAS FOUND TO BE OUT OF SPECIFICATION IN RELATION OT THE REPORTED SYMPTOM, WHICH WAS UNABLE TO BE REPRODUCED. THE DEVICE WAS TESTED FOR 24 HOURS WITH NO OCCURRENCE OF SYSTEM ERROR 322 ALARMS. SYSTEM ERROR 322 ALARMS WERE CONFIRMED THROUGH THE EVENT HISTORY LOG AND WERE DETERMINED TO BE CAUSED BY FAILED UPPER AND LOWER AUXILIARY ASSEMBLIES. THE FAILED UPPER AND LOWER AUXILIARY ASSEMBLIES WERE REPLACED. SYSTEM ERROR 322 WILL OCCUR WHEN THE PUMP TRANSITIONS FROM THE DOOR OPEN STATE TO THE DOOR CLOSE/SET-LOADED STATE AND LOWER LINK SWITCH DOES NOT ACTIVATE.
Description of Event or Problem · 1
IT WAS REPORTED THAT A SPECTRUM PUMP ALARMED SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PATIENT INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 55681 | SPECTRUM INFUSION PUMP | INFUSION PUMP | FRN | BAXTER HEALTHCARE CORPORATION | 35700 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |