FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 4012403 · Received August 15, 2014

Report

Report Number
1416980-2014-26581
Event Type
Malfunction
Date Received
August 15, 2014
Date of Event
July 23, 2014
Report Date
July 23, 2014
Manufacturer
BAXTER HEALTHCARE - SINGAPORE
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). (B)(6). THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. A VISUAL INSPECTION AND A POWER-ON SELF TEST WAS PERFORMED ON THE DEVICE. THE CAUSE OF THE DAMAGED POWER CORD COULD NOT BE DETERMINED WITH THE PROVIDED INFORMATION. THE POWER CORD WAS REPLACED TO RESOLVE THE CONDITION. 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

DURING PRODUCT EVALUATION BY A BAXTER SERVICE TECHNICIAN, A FLOGARD INFUSION PUMP WAS FOUND TO HAVE A DAMAGED POWER CORD. THIS WAS NOT REPORTED BY THE CUSTOMER. THERE WAS NO PATIENT INVOLVEMENT; THEREFORE, NO PATIENT INJURY, MEDICAL INTERVENTION, OR ADVERSE REACTION IS ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
489324 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1