FDA Adverse Event Malfunction Summary report: N

PLMA V11.51 1 N

MDR report key: 4142948 · Received September 12, 2014

Report

Report Number
9615050-2014-05199
Event Type
Malfunction
Date Received
September 12, 2014
Date of Event
July 15, 2014
Report Date
August 28, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K070398
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE PASSED TESTING BY SOUNDING AN AUDIBLE ALARM TONE DURING AN ALARM CONDITION. FURTHER TESTING BY THE SUPPLIER FOUND THAT THE TRANSISTOR GAIN VALUE (BETA) OF THE TRANSISTOR, INTERNAL TO THE PIEZO, WAS NOT SUFFICIENT TO DRIVE THE PIEZO BUZZER RESULTING IN NO AUDIBLE ALARM TONE. THIS REPORT REPRESENTS ALL THE INFO KNOWN BY THE REPORTER UPON QUERY BY HOSPIRA PERSONNEL.

Description of Event or Problem · 1

THE CUSTOMER CONTACT REPORTED THAT DURING TESTING AT THE USER FACILITY, THE DEVICE DID NOT SOUND AN AUDIBLE ALARM TONE DURING AN ALARM CONDITION. THERE WERE NO REPORTS OF ANY ADVERSE PT EVENTS AND NO REPORTED DELAYS OF CRITICAL THERAPIES WHILE THE DEVICE WAS IN CLINICAL USE. NO ADDITIONAL INFO WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
565398 PLMA V11.51 1 N 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA PLUM A+ SOFTWARE MODULE, LIST# 12097,| SN (B)(4)