FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 4100840 · Received September 19, 2014

Report

Report Number
1416980-2014-32144
Event Type
Malfunction
Date Received
September 19, 2014
Date of Event
August 26, 2014
Report Date
August 26, 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). THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. THIS IS AN ANCILLARY SERVICE EVENT EVALUATED AS PART OF PREVENTIVE MAINTENANCE. THE DEVICE WAS VISUALLY INSPECTED, FUNCTIONALLY TESTED AND A BATTERY TEST WAS PERFORMED. DURING VISUAL INSPECTION A DAMAGED LATCH ROLLER WAS IDENTIFIED; THE CAUSE WAS UNDETERMINED. TO CORRECT THE CONDITION, THE LATCH ROLLER WAS REPLACED. THE DEVICE WAS SERVICED AND RESTORED TO A GOOD WORKING CONDITION. IF ANY ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A FOLLOW UP MDR WILL BE SENT.

Description of Event or Problem · 1

DURING PRODUCT SERVICE BY A SERVICE TECHNICIAN, A FLOGARD INFUSION PUMP WAS FOUND TO HAVE A DAMAGED LATCH ROLLER. THERE WAS NO PATIENT INVOLVEMENT ASSOCIATED WITH THIS EVENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
582469 FLOGARD PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1