FDA Adverse Event
Malfunction
Summary report: N
SPECTRUM INFUSION PUMP
MDR report key: 4843872
·
Received June 3, 2015
Report
- Report Number
- 1314492-2015-06507
- Event Type
- Malfunction
- Date Received
- June 3, 2015
- Date of Event
- April 1, 2015
- Report Date
- May 11, 2015
- Manufacturer
- BAXTER HEALTHCARE CORP.
- 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). BAXTER EVALUATED THE DEVICE AND FOUND THAT THE UPSTREAM SENSOR WAS FAILING. IT WAS DETERMINED THAT THIS FAILING PART CAUSED THE FALSE UPSTREAM OCCLUSION ALARMS AND HAS BEEN REPLACED.
Description of Event or Problem · 1
DURING THE REVIEW OF THE EVENT HISTORY LOG IT WAS DETERMINED THAT A REPEATING PATTERN OF UPSTREAM OCCLUSION ALARMS SUGGESTS THAT THE DEVICE WAS FALSELY ALARMING FOR UPSTREAM OCCLUSIONS. THE OCCURRENCES SUGGEST A DEVICE MALFUNCTION. ANY PATIENT INVOLVEMENT, INJURY OR MEDICAL INTERVENTION IS UNKNOWN.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 359334 | SPECTRUM INFUSION PUMP | INFUSION PUMP | FRN | BAXTER HEALTHCARE CORP. | 35700 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |