FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3934353 · Received February 4, 2014

Report

Report Number
1314492-2014-06216
Event Type
Malfunction
Date Received
February 4, 2014
Date of Event
January 1, 2014
Report Date
January 8, 2014
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, 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 SYSTEM ERROR 105 CAUSED BY A FAILED MOTOR (FLEX). THE MOTOR ASSEMBLY WAS REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED A DEVICE IS ALARMING SYSTEM ERROR 105. IT WAS ALSO REPORTED THAT THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
72084 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1