FDA Adverse Event
Malfunction
Summary report: N
SPECTRUM INFUSION PUMP
MDR report key: 3921446
·
Received February 6, 2014
Report
- Report Number
- 1314492-2014-06549
- Event Type
- Malfunction
- Date Received
- February 6, 2014
- Date of Event
- January 1, 2014
- Report Date
- January 10, 2014
- Manufacturer
- BAXTER HEALTHCARE CORP
- Product Code
- FRN
- PMA / PMN Number
- K042121
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
(B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVAL WAS PERFORMED. EVAL CONFIRMED THE REPORTED SYMPTOM OF SYSTEM ERROR 322 THROUGH THE HISTORY LOG, BUT COULD NOT REPRODUCE IT. REVIEW OF THE KNOWN CONTRIBUTORS LED TO THE DETERMINATION THAT THE UPPER AND LOWER AUXILIARY ASSEMBLIES WERE THE FAILING COMPONENTS. THE 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 PUMP ALARMED FOR SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INVOLVEMENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 78536 | SPECTRUM INFUSION PUMP | INFUSION PUMP | FRN | BAXTER HEALTHCARE CORP | 35700 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |