FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3871359 · Received January 29, 2014

Report

Report Number
1314492-2014-04999
Event Type
Malfunction
Date Received
January 29, 2014
Date of Event
January 1, 2014
Report Date
January 2, 2014
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REF NO: (B)(4). THE DEVICE WAS RETURNED TO AND EVALUATED BY BAXTER. THE EVALUATION COULD NOT REPRODUCE THE REPORTED SYMPTOM. REVIEW OF THE EVENT HISTORY LOG CONFIRMED THE REPORTED SYMPTOM. THE EVALUATION FOUND THAT THE UPPER AND LOWER AUXILIARY ASSEMBLIES WERE FAILING, WHICH ARE KNOWN CONTRIBUTORS TO THE REPORTED SYMPTOM. THE UPPER AND LOWER AUXILIARY ASSEMBLIES WERE REPLACED. SYSTEM ERROR 322 WILL OCCUR WHEN THE PUMP TRANSITIONS FROM THE DOOR OPEN STATE TO THE DOOR CLOSED/SET-LOADED STATE AND THE 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
63689 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1