FDA Adverse Event Malfunction Summary report: N

CARDIOSAV HYBRID WITH E/F PLUG

MDR report key: 14440107 · Received May 19, 2022

Report

Report Number
2249723-2022-01174
Event Type
Malfunction
Date Received
May 19, 2022
Date of Event
April 20, 2022
Report Date
February 18, 2023
Manufacturer
DATASCOPE CORP. - MAHWAH
Product Code
DSP
UDI-DI
10607567108414
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

TYPE OF INVESTIGATION NOT YET DETERMINED: A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON RECEIPT OF ADDITIONAL INFORMATION.

Additional Manufacturer Narrative · 0

"THE DOOPLER DEVICE IABP IS A SEPARATE DEVICE. THERE WAS NO REPORTED PROBLEM WITH THE OPERATION OF THE IABP. THE DOPPLER DEVICE WAS NOT A GETINGE PRODUCT, IT WAS FROM A DIFFERENT MANUFACTURER." COMPLAINT RECORD IS BEING CLOSED/CANCELLED AS THE INFORMATION RECEIVED DOES NOT MEET THE DEFINITION OF A COMPLAINT. CORRECTED ENTIRE SECTIONS TO BLANK: B, D, E, G, H UPDATED SECTIONS: B4, G3, G6, 2, H10, H11.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) HAD A NON WORKING DOPPLER. IT IS UNKNOWN UNDER WHICH CIRCUMSTANCES THE EVENT OCCURRED OR IF A PATIENT WAS INVOLVED; HOWEVER THERE WAS NO ADVERSE EVENT REPORTED.

Description of Event or Problem · 0

THE DOOPLER DEVICE IABP IS A SEPARATE DEVICE. THERE WAS NO REPORTED PROBLEM WITH THE OPERATION OF THE IABP. THE DOPPLER DEVICE WAS NOT A GETINGE PRODUCT, IT WAS FROM A DIFFERENT MANUFACTURER. COMPLAINT RECORD IS BEING CLOSED/CANCELLED AS THE INFORMATION RECEIVED DOES NOT MEET THE DEFINITION OF A COMPLAINT.

Description of Event or Problem · 0

N/A

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2094789 CARDIOSAV HYBRID WITH E/F PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. - MAHWAH 0998-00-0800-55 N/A 10607567108414

Patients

Seq Age Sex Outcome Treatment
1 Unknown