FDA Adverse Event Malfunction Summary report: N

SORIN BCD VANGUARD BLOOD CARDIOPLEGIA SYSTEM

MDR report key: 11419576 · Received March 5, 2021

Report

Report Number
9680841-2021-00006
Event Type
Malfunction
Date Received
March 5, 2021
Date of Event
February 3, 2021
Report Date
May 4, 2021
Manufacturer
SORIN GROUP ITALIA SRL
Product Code
DTN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

LIVANOVA RECEIVED A REPORT STATING THAT AIR WAS FOUND IN THE UPPER PART OF BCD VANGUARD AFTER PRIMING. ACCORDING TO PROVIDED INFORMATION, AIR WAS NOTICED UPON COMPLETION OF PRIMING, WHEN THE NEGATIVE PRESSURE WAS APPLIED INTENTIONALLY. THERE WAS NO REPORT OF PATIENT INJURY. FOLLOW UP COMMUNICATION WITH THE CUSTOMER CLARIFIED THE PRIMING PROCEDURE WAS SUCCESSFULLY COMPLETED. THE CUSTOMER INTENTIONALLY APPLIED NEGATIVE PRESSURE TO THE DEVICE TO VERIFY IF AIR WAS INTAKE. THIS TEST IS NOT REPORTED IN THE PRODUCT IFU. RETURNED UNIT WAS VISUALLY INSPECTED AND NO DEFECT WAS NOTICED. LEAK AND FUNCTIONAL TESTS PERFORMED AT LIVANOVA LABORATORY CONFIRMED THE COMPLAINED DEVICE BEHAVED AS EXPECTED. TWO OTHER SIMILAR COMPLAINTS WERE SUBMITTED BY THE SAME CUSTOMER: THE THREE (3) EVENTS ARE ASSOCIATED TO TWO (2) DIFFERENT PRODUCT LOTS. IN ALL THREE (3) EVENTS, THE CUSTOMER CONFIRMED TO HAVE APPLIED NEGATIVE PRESSURE TO THE DEVICE. LIVANOVA BELIEVES THE REPORTED AIR PRESENCE WAS CAUSED BY THE APPLICATION OF NEGATIVE PRESSURE AND IT IS NOT ASCRIBABLE TO ANY DEVICE MALFUNCTION. THE RISK IS ACCEPTABLE. NO CORRECTIVE ACTION IS DEEMED NECESSARY. LIVANOVA WILL KEEP MONITORING THE MARKET.

Description of Event or Problem · 0

SEE INITIAL REPORT.

Additional Manufacturer Narrative · 1

THE ISSUE WAS IDENTIFIED PRIOR TO ANY PATIENT INVOLVEMENT. THE BCD VANGUARD (ITEM 050228, LOT NUMBER 2001290058 OR 2004080083) IS A NON-STERILE DEVICE THAT WAS ASSEMBLED INTO CONVENIENCE PACK MANUFACTURED BY A (B)(6) ASSEMBLER (CATALOG NUMBER UNKNOWN) THAT IS NOT DISTRIBUTED IN THE USA. THE LOT AND THE EXPIRY DATE (MM/DD/YYYY) OF THE COMPLAINED CONVENIENCE PACK ARE NOT KNOWN. AS THE STERILE CONVENIENCE PACK IS NOT DISTRIBUTED IN USA, THE UDI NUMBER IS NOT APPLICABLE. THE SORIN BIOMEDICA SMARXT BCD VANGUARD IS A NON-STERILE COMPONENT ASSEMBLED INTO A CONVENIENCE PACK THAT IS NOT DISTRIBUTED IN THE USA. THE NON-STERILE CARDIOPLEGIA HEAT EXCHANGER IS ALSO DISTRIBUTED IN THE USA (510(K)NUMBER: K934847). DEVICE MANUFACTURE DATE (MM/DD/YYYY) OF THE CONVENIENCE PACK: AS THE LOT NUMBER IS UNKNOWN, THE MANUFACTURE DATE COULD NOT BE DETERMINED. SORIN GROUP ITALIA MANUFACTURES THE SORIN BIOMEDICA SMARXT BCD VANGUARD. THE EVENT OCCURRED (B)(6). THE INVOLVED DEVICE HAS BEEN REQUESTED FOR RETURN TO SORIN GROUP ITALIA FOR INVESTIGATION AND NOT YET RECEIVED. IF ANY ADDITIONAL INFORMATION PERTINENT TO THE REPORTED EVENT IS OBTAINED, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

SORIN GROUP ITALIA HAS RECEIVED A REPORT THAT, AFTER COMPLETION OF PRIMING, AIR WAS PRESENT IN UPPER PART OF THE DEVICE. THE ISSUE WAS IDENTIFIED PRIOR TO ANY PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
319873 SORIN BCD VANGUARD BLOOD CARDIOPLEGIA SYSTEM CARDIOPLEGIA HEAT EXCHANGER DTN SORIN GROUP ITALIA SRL 2001290055 OR 2004080084

Patients

Seq Age Sex Outcome Treatment
1