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