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 |