FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3922829 · Received February 5, 2014

Report

Report Number
1314492-2014-06302
Event Type
Malfunction
Date Received
February 5, 2014
Date of Event
December 1, 2013
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
NH, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REF NO.: (B)(4). THE DEVICE HAS BEEN RECEIVED BY BAXTER FOR EVALUATION. THE INVESTIGATION HAS NOT BEEN COMPLETED AT THIS TIME. A SUPPLEMENTAL REPORT WILL BE PROVIDED WHEN THE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

DURING BAXTER'S DEVICE EVALUATION, THE DEVICE EXPERIENCED A "SYSTEM ERROR 322" ALARM. THERE WAS NO PATIENT INVOLVEMENT AS THIS WAS FOUND DURING EVALUATION OF THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
74632 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1