FDA Adverse Event Malfunction Summary report: N

FLOGARD

MDR report key: 4182750 · Received October 17, 2014

Report

Report Number
1416980-2014-36391
Event Type
Malfunction
Date Received
October 17, 2014
Date of Event
September 24, 2014
Report Date
September 24, 2014
Manufacturer
SHARP CORPORATION OSAKA JAPAN
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MX
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE FLOGARD INFUSION PUMP WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN AS PART OF PREVENTATIVE MAINTENANCE. THIS IS AN ANCILLARY SERVICE EVENT. A VISUAL INSPECTION AND A POWER ON SELF-TEST WERE PERFORMED. DURING THE POWER ON SELF-TEST A LOW BATTERY ALARM OCCURRED. THE ALARM WAS CAUSED BY A DEPLETED MAIN BATTERY. THE BATTERY WAS REPLACED; THE PUMP 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 ON-SITE SERVICE, THE BAXTER SERVICE TECHNICIAN EXPERIENCED LOW BATTERY ALARM ON A FLOGARD INFUSION PUMP. THERE WAS NO PATIENT INVOLVEMENT. ADDITIONAL INFORMATION IS NOT AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
660379 FLOGARD PUMP, INFUSION FRN SHARP CORPORATION OSAKA JAPAN

Patients

Seq Age Sex Outcome Treatment
1