FDA Adverse Event
Malfunction
Summary report: N
FLOGARD
MDR report key: 6085397
·
Received November 8, 2016
Report
- Report Number
- 1416980-2016-17027
- Event Type
- Malfunction
- Date Received
- November 8, 2016
- Date of Event
- September 20, 2016
- Report Date
- November 8, 2016
- Manufacturer
- BAXTER HEALTHCARE - SINGAPORE
- Product Code
- FRN
- PMA / PMN Number
- K915522
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MX
- Reporter Occupation
- NURSE
Narratives
Additional Manufacturer Narrative · 1
(B)(6). THE DEVICE WAS SERVICED ON-SITE BY A FIELD SERVICE TECHNICIAN. AN ALARM LOG REVIEW, FUNCTIONAL TESTING, VISUAL INSPECTION, AND SERVICE HISTORY REVIEW WERE PERFORMED. THE DEVICE CANNOT POWER ON ISSUE WAS NOT IDENTIFIED DURING DEVICE EVALUATION, HOWEVER A F-38 ALARM WAS DISCOVERED DURING THE ALARM LOG REVIEW AND FUNCTIONAL TESTING. THE CAUSE OF THE CONDITION WAS DETERMINED TO BE DAMAGED FORCE SENSING RESISTORS. THE DEVICE WAS REMOVED FROM SERVICE. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.
Description of Event or Problem · 1
IT WAS REPORTED THAT A FLO-GARD INFUSION PUMP COULD NOT POWER ON. THIS OCCURRED BEFORE USE. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 736421 | FLOGARD | PUMP, INFUSION | FRN | BAXTER HEALTHCARE - SINGAPORE | NA | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |