FDA Adverse Event
Malfunction
Summary report: N
FLOGARD
MDR report key: 6166095
·
Received December 12, 2016
Report
- Report Number
- 1416980-2016-18243
- Event Type
- Malfunction
- Date Received
- December 12, 2016
- Date of Event
- November 17, 2016
- Report Date
- December 12, 2016
- Manufacturer
- BAXTER HEALTHCARE - SINGAPORE
- Product Code
- FRN
- PMA / PMN Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MX
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
(B)(6). THE DEVICE WAS SERVICED BY A SERVICE TECHNICIAN AS PART OF PREVENTATIVE MAINTENANCE. AN ALARM LOG REVIEW, SERVICE HISTORY REVIEW, FUNCTIONAL TESTING, AND VISUAL INSPECTION WERE PERFORMED. THE F-38 ALARM WAS IDENTIFIED 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
DURING PRODUCT SERVICE BY A SERVICE TECHNICIAN, A FLO-GARD INFUSION PUMP PRESENTED AN F-38 (MALFUNCTION IN TUBE MISLOADING DETECTION CIRCUITRY) ALARM. NO ADDITIONAL INFORMATION IS AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 816958 | FLOGARD | PUMP, INFUSION | FRN | BAXTER HEALTHCARE - SINGAPORE | NA | NA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |