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