FDA Adverse Event Malfunction Summary report: N

SYMBIQ DUAL CHANNEL

MDR report key: 3874223 · Received April 18, 2014

Report

Report Number
9615050-2014-02808
Event Type
Malfunction
Date Received
April 18, 2014
Date of Event
January 13, 2014
Report Date
March 20, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K110901
Removal / Correction Number
Z-0070-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND THE TOUCHSCREEN DID NOT RESPOND WHEN PRESSED. THE PROBABLE CAUSE WAS DUE TO CONTAMINATION ON THE TOUCHSCREEN DUE TO FLUID INGRESS. THIS DEVICE HAS BEEN IDENTIFIED AS PART OF A PRODUCT RECALL. THIS REPORT REPRESENTS ALL THE INFORMATION KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING PREVENTIVE MAINTENANCE TESTING AT THE USER FACILITY, THE DEVICE TOUCHSCREEN WOULD NOT CALIBRATE. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EVENTS OR DELAYS IN CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
238531 SYMBIQ DUAL CHANNEL 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA