FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3891539 · Received January 31, 2014

Report

Report Number
1314492-2014-05203
Event Type
Malfunction
Date Received
January 31, 2014
Date of Event
December 1, 2013
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
OH, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVAL WAS PERFORMED. THE EVAL PRODUCED A CONSTANT "RELOAD SET" ALARM WHICH CORRESPONDS WITH THE SYMPTOM OF "AIR DETECTOR SENSOR" WHICH WAS REPORTED BY THE CUSTOMER. THIS FALSE MESSAGE WAS CAUSED BY A FAILED UPSTREAM SENSOR. THE UPSTREAM SENSOR WAS REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP HAD AN ISSUE WITH THE AIR DETECTOR SENSOR. IT WAS ALSO REPORTED THAT THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
68744 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1