FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3896558 · Received January 16, 2014

Report

Report Number
1314492-2014-03548
Event Type
Malfunction
Date Received
January 16, 2014
Date of Event
December 1, 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
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MFR REF NO: (B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE DEVICE WAS FOUND TO BE OUT OF SPEC IN RELATION TO THE REPORTED SYMPTOM, WHICH WAS UNABLE TO BE REPRODUCED. THE DEVICE WAS TESTED FOR 24 HOURS WITH NO OCCURRENCE OF SYSTEM ERROR 322 ALARMS. SYSTEM ERROR 322 ALARMS WERE CONFIRMED THROUGH THE EVENT HISTORY LOG AND WERE DETERMINED TO BE CAUSED BY FAILED UPPER AND LOWER AUXILIARY ASSEMBLIES. THE FAILED UPPER AND LOWER AUXILIARY ASSEMBLIES WERE 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 SPECTRUM PUMP ALARMED SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
44090 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1