FDA Adverse Event Malfunction Summary report: N

INFUSOR

MDR report key: 4172791 · Received October 15, 2014

Report

Report Number
1416980-2014-35919
Event Type
Malfunction
Date Received
October 15, 2014
Date of Event
September 20, 2014
Report Date
September 20, 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. VISUAL INSPECTION, FUNCTIONAL TESTING AND BATTERY TESTING WERE PERFORMED. THE LOW BATTERY ALARM WAS IDENTIFIED DURING BATTERY TESTING. THE CAUSE OF THE CONDITION WAS DETERMINED TO BE A DEPLETED MAIN BATTERY. TO CORRECT THE CONDITION, THE MAIN BATTERY WAS REPLACED. 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 SERVICE BY A SERVICE TECHNICIAN, A FLOGARD INFUSION PUMP WAS FOUND TO HAVE A LOW BATTERY ALARM. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
654776 INFUSOR PUMP, INFUSION FRN BAXTER HEALTHCARE - SINGAPORE

Patients

Seq Age Sex Outcome Treatment
1