FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3935149 · Received February 3, 2014

Report

Report Number
1314492-2014-05620
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
MN, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(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

IT WAS REPORTED THAT A PUMP ALARMED SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
69846 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1