FDA Adverse Event Malfunction Summary report: N

SPECTRUM INFUSION PUMP

MDR report key: 8621725 · Received May 17, 2019

Report

Report Number
1314492-2019-01730
Event Type
Malfunction
Date Received
May 17, 2019
Date of Event
April 25, 2019
Report Date
May 17, 2019
Manufacturer
BAXTER HEALTHCARE - MEDINA
Product Code
FRN
UDI-DI
00085412498683
PMA / PMN Number
K133801
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

BAXTER RECEIVED AND EVALUATED THE DEVICE. VISUAL INSPECTION DID NOT IDENTIFY ANY ABNORMALITIES THAT COULD HAVE CONTRIBUTED TO THE REPORTED CONDITION. A DEVICE HISTORY REVIEW REVEALED NO ISSUES THAT COULD HAVE CAUSED OR CONTRIBUTED TO THE REPORTED ISSUE. THE REPORTED CONDITION WAS VERIFIED. THE DEVICE WAS FOUND OUT OF SPECIFICATION IN RELATION TO THE REPORTED DOESN'T DETECT OPEN DOOR WHICH WAS REPRODUCED DURING EVALUATION AND FOUND TO BE CAUSED BY A FAILED UPPER LATCH SWITCH. THE UPPER AUXILIARY WAS REPLACED TO CORRECT THIS CONDITION. SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT A SPECTRUM PUMP DID NOT DETECT OPEN DOOR DURING PROGRAMMING OR SETUP. THERE WAS NO PATIENT INVOLVEMENT. NO ADDITIONAL INFORMATION IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
413601 SPECTRUM INFUSION PUMP INFUSION PUMP FRN BAXTER HEALTHCARE - MEDINA NA NA 00085412498683

Patients

Seq Age Sex Outcome Treatment
1