FDA Adverse Event Malfunction Summary report: N

SYMBIQ 3.13 SINGLE C

MDR report key: 4143027 · Received September 12, 2014

Report

Report Number
9615050-2014-05221
Event Type
Malfunction
Date Received
September 12, 2014
Date of Event
January 1, 2014
Report Date
September 3, 2014
Manufacturer
HOSPIRA COSTA RICA LTD.
Product Code
FRN
PMA / PMN Number
K110901
Removal / Correction Number
Z-0069-2013
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A FIELD SERVICE ENGINEER PERFORMED TESTING AND INVESTIGATION AT THE USER FACILITY. DURING TESTING, THE TOUCH POINTS ON THE TOUCHSCREEN WERE FOUND TO BE OFF CENTER. THIS WAS DUE TO THE TOUCHSCREEN BEING 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 WAS OUT OF CALIBRATION. 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, IT WAS NOTED THAT THE TOUCH POINTS ON THE TOUCHSCREEN WERE OFF CENTER WHEN PRESSED. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
565202 SYMBIQ 3.13 SINGLE C 80FRN FRN HOSPIRA COSTA RICA LTD. NA NA

Patients

Seq Age Sex Outcome Treatment
1 NA