FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 4963227 · Received August 4, 2015

Report

Report Number
1314492-2015-08261
Event Type
Malfunction
Date Received
August 4, 2015
Date of Event
June 1, 2015
Report Date
July 16, 2015
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K042121
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, 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 AIR IN LINE ALARMS AND HAS BEEN REPLACED.

Description of Event or Problem · 1

DURING REVIEW OF THE EVENT HISTORY LOG IT WAS DETERMINED THAT A REPEATING PATTERN OF AIR-IN-LINE ALARMS SUGGESTS THAT THE DEVICE WAS FALSELY ALARMING FOR AIR-IN-LINE. 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
508499 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1