FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 5636563 · Received May 6, 2016

Report

Report Number
1314492-2016-02815
Event Type
Malfunction
Date Received
May 6, 2016
Date of Event
April 4, 2016
Report Date
April 14, 2016
Manufacturer
BAXTER HEALTHCARE CORPORATION
Product Code
FRN
PMA / PMN Number
K133801
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REF NO.: (B)(4). THE DEVICE WAS NOT RETURNED TO BAXTER FOR EVALUATION. THEREFORE, AN EVALUATION COULD NOT BE COMPLETED. IF THE DEVICE IS RETURNED, AN EVALUATION WILL BE COMPLETED AND A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP DELIVERED AT A LOWER RATE OR VOLUME THAN PROGRAMMED (UNDER INFUSION) OF PLATELETS DURING THERAPY IN UNIT 57 ONCOLOGY, HEMATOLOGY, BMT. THE CUSTOMER REPORTED THAT THE PUMP WAS SET TO INFUSE 347 MLS OF PLATELETS AT 833 ML/HR. HOWEVER, WHEN THE PUMP INDICATED THE INFUSION WAS COMPLETE, THE REPORTER WAS REQUIRED TO ADD 98 MLS OF FLUID TO BE INFUSED. THE SET USED WITH THE PUMP WAS "BLOOD Y-TYPE IV ADMINISTRATION SET W/ 170-260 MICRON FILTER, PRODUCT CODE JC7751, LOT # UNKNOWN." IT WAS ALSO REPORTED THERE WAS NO PATIENT INJURY OR MEDICAL INTERVENTION PROVIDED AS A RESULT OF THIS UNDER INFUSION EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
292132 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE CORPORATION 35700

Patients

Seq Age Sex Outcome Treatment
1