FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3922349 · Received February 5, 2014

Report

Report Number
1314492-2014-06263
Event Type
Malfunction
Date Received
February 5, 2014
Date of Event
January 1, 2014
Report Date
January 9, 2014
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REF NO.: (B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVALUATION WAS PERFORMED. THE EVALUATION CONFIRMED AND REPRODUCED THE REPORTED SYMPTOM SYSTEM ERROR 105 CAUSED BY A FAILED MOTOR. THE MOTOR ASSEMBLY WAS REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP ALARMED SYSTEM ERROR 105. THERE WAS NO REPORTED PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
75278 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1