BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BIO-CONSOLE

    MDR report key: 115718 · Received August 20, 1997

    Report

    Report Number
    2124837-1997-00018
    Event Type
    Malfunction
    Date Received
    August 20, 1997
    Date of Event
    July 22, 1997
    Report Date
    August 19, 1997
    Manufacturer
    MEDTRONIC BIO-MEDICUS, INC.
    Product Code
    DWA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SD, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    HOSP REPORTED THAT DURING A CASE, THE PERFUSIONIST NOTICED THE BLOOD RESERVOIR WAS FILLING, AND THE BIO-CONSOLE WAS CHANGED OUT WITH AN EMERGENCY HANDCRANK UNTIL A BACK-UP CONSOLE WAS PUT IN PLACE. THE CASE WAS CONTINUED WITH NO EFFECT TO THE PT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BIO-CONSOLE CARDIOPULMONARY BYPASS PUMP SPEED CONTROLLER DWA MEDTRONIC BIO-MEDICUS, INC. 540 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 4 YR Other