FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3891058 · Received January 31, 2014

Report

Report Number
1314492-2014-05329
Event Type
Malfunction
Date Received
January 31, 2014
Date of Event
January 1, 2014
Report Date
January 6, 2014
Manufacturer
BAXTER HEALTHCARE 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 NO.: (B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. EVALUATION EXPERIENCED SYSTEM ERROR 322 DURING THE EVALUATION. PHYSICAL INSPECTION FOUND THAT THE UPPER AND LOWER LATCH SWITCH BRACKET SCREWS WERE LOOSE ALLOWING THE UPPER AND LOWER LATCH SWITCH TO MOVE IN AND OUT FROM THE UPPER AND LOWER DOOR LATCH. THE LOOSE NYLON SCREWS WILL TRIGGER AN INTERMITTENT OPEN/CLOSED SWITCH CONNECTION CAUSING THE SYSTEM ERROR 322. THE UPPER AND LOWER AUXILIARY ASSEMBLIES HAVE BEEN 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 PUMP HAS A SYSTEM ERROR 322 IN THE HISTORY LOG. ANY PATIENT INVOLVEMENT, INJURY OR MEDICAL INTERVENTION IS UNKNOWN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
67367 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1