FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 3973355 · Received August 1, 2014

Report

Report Number
1416980-2014-25068
Event Type
Malfunction
Date Received
August 1, 2014
Date of Event
July 7, 2014
Report Date
July 7, 2014
Manufacturer
SHARP CORPORATION OSAKA JAPAN
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(6). (B)(6). EVALUATION SUMMARY: THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. VISUAL INSPECTION, FUNCTIONAL TESTING AND A REVIEW OF THE ALARM LOG WAS PERFORMED. FUNCTIONAL TESTING AND THE REVIEW OF THE ALARM LOG REVEALED THAT THE DEVICE HAD PRESENTED AN F-38 ALARM. THE CAUSE OF THE CONDITION WAS DETERMINED TO BE FORCE SENSING RESISTORS (FSRS) OUT OF SPECIFICATION. TO CORRECT THE CONDITION, THE FSRS WERE REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A FLOGARD INFUSION PUMP EXPERIENCED AN F-38 ALARM. THERE WAS NO PATIENT INVOLVEMENT. ADDITIONAL INFORMATION WAS REQUESTED AND IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
450714 FLOGARD PUMP, INFUSION FRN SHARP CORPORATION OSAKA JAPAN

Patients

Seq Age Sex Outcome Treatment
1