FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUM

MDR report key: 4422125 · Received May 19, 2014

Report

Report Number
1314492-2014-31681
Event Type
Malfunction
Date Received
May 19, 2014
Date of Event
April 1, 2014
Report Date
May 2, 2014
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED AND EVALUATED BY BAXTER. THIS COMPLAINT WAS OPENED DURING THE INVESTIGATION OF (B)(4). THE AIR-IN-LINE ALARMS WERE CONFIRMED THROUGH AN EVENT HISTORY LOG REVIEW. THE CAUSE WAS UNDETERMINED. IF ANY ADDITIONAL INFORMATION IS RECEIVED A FOLLOW UP WILL BE SENT. THE ULTRASONIC PUSHER AND ULTRASONIC SENSOR WERE REPLACED.

Description of Event or Problem · 1

DURING THE EVALUATION OF A RETURNED SPECTRUM INFUSION PUMP, 37 OCCURRENCES OF ¿AIR-IN-LINE¿ ALARMS WERE IDENTIFIED IN THE EVENT HISTORY LOG. ANY PATIENT INVOLVEMENT, INJURY OR MEDICAL INTERVENTION IS UNKNOWN SINCE THESE ITEMS WERE FOUND DURING EVALUATION OF THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
298189 SPECTRUM INFUSION PUM INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1