FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 3935655 · Received February 3, 2014

Report

Report Number
1314492-2014-05628
Event Type
Malfunction
Date Received
February 3, 2014
Date of Event
January 1, 2014
Report Date
January 7, 2014
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). BAXTER RECEIVED AND EVALUATED THE DEVICE. THE DEVICE WAS FOUND OUT OF SPEC IN RELATION TO THE REPORTED SYMPTOM WHICH WAS NOT REPRODUCED. THE DEVICE WAS TESTED FOR 24 HOURS AND NO MALFUNCTION COULD BE IDENTIFIED. SYSTEM ERROR 322 WAS CONFIRMED THROUGH THE EVENT HISTORY LOG. THE EVAL WAS UNABLE TO DETERMINE THE CAUSE. THE UPPER AND LOWER AUXILIARY ARE KNOWN CONTRIBUTORS TO THIS SYMPTOM NAD HAVE BEEN REPLACED. IT WAS REPORTED THAT A DEVICE IS ALARMING SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Description of Event or Problem · 1

IT WAS REPORTED THAT A DEVICE IS ALARMING SYSTEM ERROR 322. IT WAS ALSO REPORTED THAT THERE WAS NO PT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
69884 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1