FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, TYPE B PLUG

MDR report key: 13209423 · Received January 10, 2022

Report

Report Number
2249723-2022-00048
Event Type
Malfunction
Date Received
January 10, 2022
Date of Event
December 17, 2021
Report Date
October 10, 2022
Manufacturer
DATASCOPE CORP. - MAHWAH
Product Code
DSP
UDI-DI
10607567108391
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INITIAL REPORTER¿S NAME IS SHORTENED DUE TO FIELD CHARACTER LIMIT. THE FULL NAME IS (B)(6). TESTING OF ACTUAL/SUSPECTED DEVICE ((B)(4)): THE CUSTOMER DID NOT REQUEST SERVICE; HOWEVER, THE CUSTOMER CALLED A GETINGE EMERGENCY REPRESENTATIVE (GER) FOR ASSISTANCE. THE GER GUIDED THE CUSTOMER THROUGH RELOADING THE RESCUE IABP UNIT INTO THE HOSPITAL CART, WHICH RESOLVED THE ISSUE. THE HYBRID ICON AND ELECTRICAL PLUG ICONS WERE NOW VISIBLE. ADDITIONAL INFORMATION IS BEING REQUESTED WITH REGARD TO THE STATUS OF THE IABP. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION.

Additional Manufacturer Narrative · 0

THE INITIAL REPORTER¿S NAME IS SHORTENED DUE TO FIELD CHARACTER LIMIT. THE FULL NAME IS (B)(6). THE CUSTOMER DID NOT REQUEST SERVICE; HOWEVER, THE CUSTOMER CALLED A GETINGE EMERGENCY REPRESENTATIVE (GER) FOR ASSISTANCE. THE GER GUIDED THE CUSTOMER THROUGH RELOADING THE RESCUE IABP UNIT INTO THE HOSPITAL CART, WHICH RESOLVED THE ISSUE. THE HYBRID ICON AND ELECTRICAL PLUG ICONS WERE NOW VISIBLE. ADDITIONAL INFORMATION IS BEING REQUESTED WITH REGARD TO THE STATUS OF THE IABP. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION.

Additional Manufacturer Narrative · 0

UPDATED FIELDS: A2, A3, A4, B4, D9, G3, G6, G7, H2, H4, H6 (TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, INVESTIGATION CONCLUSIONS), H10, H11. CORRECTED FIELD: G1 (CONTACT PERSON ¿ MFG SITE). PATIENT OR PERSON HEIGHT (CM): 180.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USE WHEN THE PATIENT ARRIVED FROM THE CCL, THE ICU REGISTERED NURSE (RN) PLUGGED IN THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) AND NOTED THAT THE BATTERY WAS STILL IN USE. THERE WAS NO HARM OR INJURY TO THE PATIENT AND NO ADVERSE EVENT WAS REPORTED .

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USE WHEN THE PATIENT ARRIVED FROM THE CCL, THE ICU REGISTERED NURSE (RN) PLUGGED IN THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) AND NOTED THAT THE BATTERY WAS STILL IN USE. THERE WAS NO HARM OR INJURY TO THE PATIENT AND NO ADVERSE EVENT WAS REPORTED .

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
981876 CARDIOSAVE HYBRID, TYPE B PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. - MAHWAH 0998-00-0800-53 N/A 10607567108391

Patients

Seq Age Sex Outcome Treatment
1 76 YR Male