FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3880131 · Received January 30, 2014

Report

Report Number
1314492-2014-05100
Event Type
Malfunction
Date Received
January 30, 2014
Date of Event
January 3, 2014
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MFR REF NO.: (B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVALUATION WAS PERFORMED. THIS COMPLAINT WAS OPENED DURING THE INVESTIGATION OF COMPLAINT (B)(4). THE UNDETECTED UPSTREAM OCCLUSION EXPERIENCED DURING TESTING WAS NOT ABLE TO BE REPRODUCED, AND THE DEVICE WAS DETERMINED TO BE WITHIN SPECIFICATION.

Description of Event or Problem · 1

DURING BAXTER'S DEVICE EVALUATION, THE DEVICE FAILED TO DETECT AN UPSTREAM OCCLUSION. THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
65052 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1