FDA Adverse Event Malfunction Summary report: N

COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP

MDR report key: 648537 · Received November 28, 2005

Report

Report Number
6000001-2005-07256
Event Type
Malfunction
Date Received
November 28, 2005
Date of Event
November 1, 2005
Report Date
November 2, 2005
Manufacturer
BAXTER HEALTHCARE PTE. LTD.
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Description of Event or Problem · 1

THE FACILITY REPORTED AN INFUSION PUMP WITH A FAILURE CODE 570:320:844:000. INFORMATION WAS NOT PROVIDED REGARDING WHETHER OR NOT THE DEVICE WAS IN PATIENT USE WHEN THE EVENT OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COLLEAGUE 3CX VOLUMETRIC INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE PTE. LTD. COLLEAGUE 3CX NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN