FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3882173 · Received June 18, 2014

Report

Report Number
1416980-2014-19426
Event Type
Malfunction
Date Received
June 18, 2014
Date of Event
May 25, 2014
Report Date
May 25, 2014
Manufacturer
SHARP CORPORATION OSAKA JAPAN
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS SERVICED AT THE CUSTOMER SITE BY A FIELD SERVICE TECHNICIAN. THE DEVICE WAS VISUALLY INSPECTED, FUNCTIONALLY TESTED, THE ALARM LOG WAS REVIEWED AND A POWER ON SELF-TEST WAS PERFORMED. THE REPORTED CONDITION OF DAMAGED DOOR LATCH WAS RELATED TO A DOOR OPEN ALARM WHICH WAS FOUND IN THE POWER ON SELF-TEST AND ALARM LOG. TO RESOLVE THE ISSUE THE LATCH DOOR WAS REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. IF ANY ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A FOLLOW UP MDR WILL BE SENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT A FLOGARD INFUSION PUMP HAD A DAMAGED DOOR LATCH. THERE WAS NO PATIENT INVOLVEMENT. ADDITIONAL INFORMATION WAS REQUESTED AND IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
358353 FLOGARD PUMP, INFUSION FRN SHARP CORPORATION OSAKA JAPAN

Patients

Seq Age Sex Outcome Treatment
1