FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3935057 · Received February 4, 2014

Report

Report Number
1314492-2014-06229
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
MN, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE REPORTED SYSTEM ERROR 322 WAS CONFIRMED THROUGH REVIEW OF THE EVENT HISTORY LOG, BUT WAS NOT REPRODUCED. IT HAS BEEN DETERMINED THAT THE UPPER AND LOWER AUXILIARY WERE THE FAILING COMPONENTS WHICH CAUSED THIS ERROR. THE UPPER AND LOWER AUXILIARY WERE REPLACED. SYSTEM ERROR 322 WILL OCCUR WHEN THE PUMP TRANSITIONS FROM THE DOOR OPEN STATE TO THE DOOR CLOSED/SET-LOADED STATE AND THE LOWER LINK SWITCH DOES NOT ACTIVATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT A PUMP ALARMED FOR A SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
72566 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1