FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3880049 · Received January 31, 2014

Report

Report Number
1314492-2014-05285
Event Type
Malfunction
Date Received
January 31, 2014
Date of Event
January 6, 2014
Report Date
January 6, 2014
Manufacturer
BAXTER HLTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REF: (B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. EVAL REPRODUCED AND CONFORMED THE REPORTED SYMPTOM OF SYSTEM ERROR 322. PHYSICAL INSPECTION FOUND THAT THE UPPER LATCH SWITCH BRACKET SCREWS WERE LOOSE ALLOWING THE UPPER LATCH SWITCH TO MOVE IN AND OUT FROM THE UPPER DOOR LATCH. THE LOOSE SCREWS WILL TRIGGER AN INTERMITTENT OPEN/CLOSED SWITCH CONNECTION CAUSING THE SYMPTOM. THE UPPER AUXILIARY ASSEMBLY WAS REPLACED. SYS 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 HAD A SYSTEM ERROR 322. ANY PT INVOLVEMENT, INJURY OR MEDICAL INTERVENTION IS UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
67450 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HLTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1