FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3896664 · Received January 16, 2014

Report

Report Number
1314492-2014-03583
Event Type
Malfunction
Date Received
January 16, 2014
Date of Event
December 1, 2013
Report Date
December 23, 2013
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REF NO.: (B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE REPORTED SYSTEM ERROR 322 WAS CONFIRMED THROUGH EVALUATION. PHYSICAL INSPECTION FOUND THAT THE UPPER AND LOWER LATCH SWITCH BRACKET SCREWS WERE LOOSE ALLOWING THE UPPER AND LOWER LATCH SWITCHES TO MOVE IN AND OUT FROM THE UPPER AND LOWER DOOR LATCHES. THE LOOSE SCREWS WILL TRIGGER AN INTERMITTENT OPEN/CLOSED SWITCH CONNECTION CAUSING THE REPORTED SYMPTOM. THE UPPER AND LOWER AUXILIARY WERE REPLACED.

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 PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
43611 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1