FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3896556 · Received January 16, 2014

Report

Report Number
1314492-2014-03545
Event Type
Malfunction
Date Received
January 16, 2014
Date of Event
December 2, 2013
Report Date
December 20, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
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 RECEIVED AND EVALUATED BY BAXTER. THE REPORTED SYMPTOM COULD NOT BE REPRODUCED DURING TESTING. THE SYSTEM ERROR 322 WAS CONFIRMED THROUGH THE HISTORY LOG. 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. THE UPPER AND LOWER AUXILIARY COMPONENTS WERE REPLACED AS THEY ARE KNOWN TO CONTRIBUTE TO THE SYSTEM ERROR 322.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP DISPLAYED SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
44146 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1