FDA Adverse Event Malfunction Summary report: N

HEATER-COOLER SYSTEM 3T

MDR report key: 13589456 · Received February 24, 2022

Report

Report Number
9611109-2022-00079
Event Type
Malfunction
Date Received
February 24, 2022
Report Date
February 24, 2022
Manufacturer
LIVANOVA DEUTSCHLAND
Product Code
DWC
UDI-DI
04033817901099
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THERE WAS NO PATIENT INVOLVEMENT. SERIAL NUMBER IS UNKNOWN. THIS INFORMATION WILL BE PROVIDED IN A SUPPLEMENTAL REPORT IF MADE AVAILABLE. AS THE SERIAL NUMBER IS UNKNOWN, THE DEVICE MANUFACTURE DATE COULD NOT BE DETERMINED. THIS INFORMATION WILL BE PROVIDED IN A SUPPLEMENTAL REPORT IF MADE AVAILABLE. THE HEATER-COOLER 16-02-80 IS NOT DISTRIBUTED IN THE USA, BUT IT IS SIMILAR TO HEATER-COOLER 16-02-85, WHICH IS DISTRIBUTED IN THE USA (510(K) NUMBER: K191402). LIVANOVA (B)(4) MANUFACTURES THE HEATER-COOLER SYSTEM 3T. THE INCIDENT OCCURRED IN (B)(6). LIVANOVA INITIATED AN INVESTIGATION. IF ANY ADDITIONAL INFORMATION PERTINENT TO THE REPORTED EVENT IS RECEIVED, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

Additional Manufacturer Narrative · 0

THERE WAS NO PATIENT INVOLVEMENT. SERIAL NUMBER IS UNKNOWN. THIS INFORMATION WILL BE PROVIDED IN A SUPPLEMENTAL REPORT IF MADE AVAILABLE. AS THE SERIAL NUMBER IS UNKNOWN, THE DEVICE MANUFACTURE DATE COULD NOT BE DETERMINED. THIS INFORMATION WILL BE PROVIDED IN A SUPPLEMENTAL REPORT IF MADE AVAILABLE. THE HEATER-COOLER 16-02-80 IS NOT DISTRIBUTED IN THE USA, BUT IT IS SIMILAR TO HEATER-COOLER 16-02-85, WHICH IS DISTRIBUTED IN THE USA (510(K) NUMBER: K191402). LIVANOVA (B)(4) MANUFACTURES THE HEATER-COOLER SYSTEM 3T. THE INCIDENT OCCURRED IN (B)(6). LIVANOVA INITIATED AN INVESTIGATION. IF ANY ADDITIONAL INFORMATION PERTINENT TO THE REPORTED EVENT IS RECEIVED, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

Additional Manufacturer Narrative · 0

CUSTOMER INFORMATION HAS BEEN ADDED TO THE DEDICATED E SECTION. THROUGH FOLLOW UP COMMUNICATIONS LIVANOVA BECAME AWARE OF DEVICE MODEL/SERIAL NUMBERS WHICH HAVE BEEN ADDED TO THE DEDICATED D.4 SECTION. THE DEVICE MANUFACTURING DATE HAS BEEN ADDED ACCORDINGLY TO H.4 SECTION. H.10: THROUGH A FOLLOW UP COMMUNICATION IT WAS LEARNT THAT THE STIRRER MOTOR IN PATIENT BRIDGE STOPPED DURING PRIMING AND THAT NO ERROR CODE WAS NOTICED BY THE USER. IT WAS REPORTED THAT ERROR WAS NOT NOTICED AND STIRRER MOTOR WAS NOISY IN EARLY PHASE AND THEN STOP FOR A MOMENT AND THEN STARTED AGAIN. IN ADDITION, IT WAS LEARNT THAT THE STIRRER MOTOR WAS REPLACED AND THE UNIT WAS PUT BACK IN SERVICE IN ITS EXPECTED FUNCTION. THE INVOLVED DEVICE WAS MANUFACTURED IN 2017 AND ACCORDING TO THE ANALYSIS OF THE COMPLAINTS DATABASE NO FURTHER EVENTS RELATED TO THIS UNIT HAVE BEEN REPORTED IN THE PAST. THE ISSUE IS MORE LIKELY ASSOCIATED TO THE MOTOR BEARING DAMAGED BY THE CORROSION, WHICH CONSEQUENTLY DOES NOT ALLOW THE MOTOR SHAFT TO ROTATE. POSSIBLE CAUSES ARE WATER INFILTRATION OR WATER FORMATION DUE TO CONDENSATION OR HIGH TEMPERATURES AND HIGH LEVEL OF HUMIDITY IN THE STATIONARY PHASE. CAUSES RELATED TO ENVIRONMENTAL CONDITIONS.

Description of Event or Problem · 0

LIVANOVA DEUTSCHLAND RECEIVED A REPORT OF NOISE AND INTERMEDIATE STOP OF A HEATER-COOLER SYSTEM 3T DURING PRIMING. NO FURTHER DETAILS ARE CURRENTLY AVAILABLE.THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

LIVANOVA (B)(4) RECEIVED A REPORT OF NOISE AND INTERMEDIATE STOP OF A HEATER-COOLER SYSTEM 3T DURING PRIMING. NO FURTHER DETAILS ARE CURRENTLY AVAILABLE. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

SEE INITIAL REPORT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1080340 HEATER-COOLER SYSTEM 3T CONTROLLER, TEMPERATURE, CARDIOPULMONARY BYPASS DWC LIVANOVA DEUTSCHLAND 16-02-80 04033817901099

Patients

Seq Age Sex Outcome Treatment
1 Unknown