FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3935126 · Received February 3, 2014

Report

Report Number
1314492-2014-05621
Event Type
Malfunction
Date Received
February 3, 2014
Date of Event
January 1, 2014
Report Date
January 7, 2014
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
NOT APPLICABLE

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 UNDETECTED UPSTREAM OCCLUSION CAUSED BY A DRIED SOLUTION ON THE UPSTREAM SENSOR ASSEMBLY. THE DRIED SOLUTION WAS REMOVED AND THE DEVICE WAS CALIBRATED TO ENSURE PROPER OCCLUSION DETECTION.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP WOULD NOT DETECT AN UPSTREAM OCCLUSION. IT WAS ALSO REPORTED THAT THERE WAS NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
69457 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1