FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3903007 · Received June 30, 2014

Report

Report Number
1416980-2014-20892
Event Type
Malfunction
Date Received
June 30, 2014
Date of Event
June 5, 2014
Report Date
June 5, 2014
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVALUATION SUMMARY: THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. THIS IS AN ANCILLARY SERVICE EVENT. VISUAL INSPECTION, FUNCTIONAL TESTING, AND BATTERY TESTING WERE PERFORMED. FUNCTIONAL TESTING REVEALED THAT THE DEVICE HAD PRESENTED AN F-94 ALARM. THE CAUSE OF THE CONDITION WAS DETERMINED TO BE A FULLY DISCHARGED MAIN BATTERY. TO CORRECT THE CONDITION, THE MAIN BATTERY WAS REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

DURING PRODUCT SERVICE BY A SERVICE TECHNICIAN, A FLOGARD INFUSION PUMP WAS FOUND TO HAVE PRESENTED AN F-94 ALARM. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
380701 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1