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 |