FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3934122 · Received February 1, 2014

Report

Report Number
1314492-2014-07305
Event Type
Malfunction
Date Received
February 1, 2014
Date of Event
January 14, 2014
Report Date
January 14, 2014
Manufacturer
BAXTER HEALTHCARE CORPORATION
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

MANUFACTURER REF NO.: (B)(4). THE DEVICE WAS RETURNED TO BAXTER AND EVALUATED. THE EVALUATION EXPERIENCED FALSE UPSTREAM OCCLUSION ALARMS CAUSED BY CRACKS IN THE UPSTREAM SENSOR TAIL PINS. THE FAILED UPSTREAM SENSOR WAS REPLACED.

Description of Event or Problem · 1

IT WAS FOUND DURING A BAXTER EVALUATION THAT A PUMP HAS FALSE UPSTREAM OCCLUSION ALARMS. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
69373 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1