FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 4447895 · Received June 16, 2014

Report

Report Number
1314492-2014-37441
Event Type
Malfunction
Date Received
June 16, 2014
Date of Event
May 1, 2014
Report Date
May 22, 2014
Manufacturer
BAXTER HEALTHCARE CORP
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RETURNED TO BAXTER AND AN EVAL WAS PERFORMED. THE EVAL CONFIRMED AND REPRODUCED THE REPORTED DOWNSTREAM OCCLUSION ALARMS. THE DOWNSTREAM PRESSURE PLATE HAP WAS OUT OF SPEC, RESULTING IN HIGH DOWNSTREAM SENSOR READINGS. THE DOWNSTREAM TUBING GUIDE WAS REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP HAD A DOWNSTREAM OCCLUSION ALARM. IT WAS ALSO REPORTED THAT THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
353725 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORP 35700

Patients

Seq Age Sex Outcome Treatment
1