FDA Adverse Event Malfunction Summary report: N

SYMBIQ SINGLE CHANNEL

MDR report key: 3902089 · Received May 2, 2014

Report

Report Number
9615050-2014-03169
Event Type
Malfunction
Date Received
May 2, 2014
Date of Event
April 1, 2014
Report Date
April 2, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K110901
Removal / Correction Number
Z-0069-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TESTING AND INVESTIGATION FOUND THE TOUCHSCREEN DID NOT RESPOND. THE PROBABLE CAUSE WAS DUE TO CONTAMINATION ON THE BOTTOM OF THE TOUCHSCREEN DUE TO FLUID INGRESS. THIS DEVICE HAS BEEN IDENTIFIED AS PART OF A PRODUCT RECALL. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THE DEVICE TOUCHSCREEN SEEMS BROKEN, DOES NOT RESPOND. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS AND NO REPORTED DELAYS OF CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. DURING TESTING AT THE USER FACILITY, THE DEVICE TOUCHSCREEN DOES NOT RESPOND WHEN PRESSED. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
265614 SYMBIQ SINGLE CHANNEL 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA