FDA Adverse Event Malfunction Summary report: N

SYMBIQ DUAL CHANNEL

MDR report key: 4142865 · Received September 30, 2014

Report

Report Number
9615050-2014-05427
Event Type
Malfunction
Date Received
September 30, 2014
Date of Event
January 1, 2014
Report Date
September 16, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K110901
Removal / Correction Number
Z-0070-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A FIELD SERVICE ENGINEER PERFORMED TESTING AND INVESTIGATION AT THE USER FACILITY. DURING TESTING THE TOUCHSCREEN WAS FOUND TO NOT RESPOND WHEN PRESSED. THE PROBABLE CAUSE WAS DUE TO THAT THE DEVICE TOUCHSCREEN WAS OUT OF CALIBRATION. THE DEVICE HAS BEEN IDENTIFIED AS PART OF A PRODUCT RECALL. THIS REPORT REPRESENTS ALL THE INFORMATION KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THE DEVICE TOUCHSCREEN BUTTONS NOT WORKING. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EVENTS OR DELAYS IN CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. DURING TESTING AT THE USER FACILITY THE DEVICE TOUCHSCREEN WAS NOT RESPONSIVE. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
607046 SYMBIQ DUAL CHANNEL 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA