FDA Adverse Event Malfunction Summary report: N

SABRATEK 6060 HOMERUN PUMP

MDR report key: 735803 · Received June 24, 2005

Report

Report Number
6000001-2005-02351
Event Type
Malfunction
Date Received
June 24, 2005
Date of Event
April 1, 2005
Report Date
June 14, 2005
Manufacturer
BAXTER HEALTHCARE (SG)
Product Code
FRN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHARMACIST

Narratives

Additional Manufacturer Narrative · 1

PUMP HAS NOT BEEN RECEIVED FOR EVALUATION. TESTING WAS PERFORMED BY MEDICAL SPECIALTIES AND OVERINFUSION WAS NOT CONFIRMED. PUMP PASSED ALL ACCURACY TESTS PERFORMED BY MEDICAL SPECIALTIES. BAXTER WILL CONTINUE TO INVESTIGATE ANY REPORTS IT RECEIVES AND REVIEW TRENDING OF THESE EVENTS.

Description of Event or Problem · 1

CUSTOMER SENT MEDWATCH TO FDA ON 4/21/2005 #1035274. BAXTER RECEIVED COPY OF MEDWATCH ON 6/14/2005. CUSTOMER REPORTED THE PUMP WAS PROGRAMMED TO DELIVER MEDICATIONS OVER AN 11 HOUR PERIOD. PT RAN OUT OF MEDICATION 1 HOUR PRIOR TO THE TIME IT WAS SUPPOSED TO FINISH (10 HOURS). NO PT INJURY HAS BEEN REPORTED AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SABRATEK 6060 HOMERUN PUMP SABRATEK 6060 PUMP FRN BAXTER HEALTHCARE (SG) NA NA

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN