FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3921582 · Received February 6, 2014

Report

Report Number
1314492-2014-06568
Event Type
Malfunction
Date Received
February 6, 2014
Date of Event
January 1, 2014
Report Date
January 10, 2014
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

MFR REF NO: (B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE REPORTED SYSTEM ERROR 105 WAS REPRODUCED AND CONFIRMED DURING EVAL. THIS ERROR MESSAGE HAS BEEN ATTRIBUTED TO A FAILED MOTOR (FLEX). THE MOTOR ASSEMBLY WAS REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP HAD SYSTEM ERROR 105 ALARMS. ANY PT INVOLVEMENT, INJURY OR MEDICAL INTERVENTION IS UNK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
76503 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1