FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, TYPE G PLUG

MDR report key: 15950511 · Received December 9, 2022

Report

Report Number
2249723-2022-03148
Event Type
Malfunction
Date Received
December 9, 2022
Date of Event
November 28, 2022
Report Date
February 24, 2024
Manufacturer
DATASCOPE CORP. - MAHWAH
Product Code
DSP
UDI-DI
10607567108438
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SN
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION.

Additional Manufacturer Narrative · 0

UPDATED FIELDS - B4, D9, E1(SITE COUNTRY), G3, G6, H2, H3, H4, H6 (TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, INVESTIGATION CONCLUSIONS), H10, H11. CORRECTED FIELDS: (B)(6). ADDITIONAL INFORMATION: E1(EVENT SITE POSTAL CODE: (B)(6). A GETINGE FIELD SERVICE ENGINEER (FSE) EVALUATED THE IABP UNIT WHICH WAS HAVING  PNEUMATIC MODULE TEST FAIL ISSUE. TO FIX THIS ISSUE FSE REPLACED NEW SAFETY DISK. ALL MANIFOLD TEST PASSED. ALL FUNCTIONAL SAFETY CHECKS HAVE BEEN MADE TO MEET FACTORY SPECIFICATIONS. THE IABP RETURNED TO THE CUSTOMER FOR USE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING PREPARATION, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) NHC RP ERROR OCCURRED DURING PNEUMATIC MODULE TEST.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING PREPARATION, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) NHC RP ERROR OCCURRED DURING PNEUMATIC MODULE TEST. THERE WAS NO PATIENT INVOLVEMENT

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2842247 CARDIOSAVE HYBRID, TYPE G PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. - MAHWAH 0998-00-0800-52 10607567108438

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown N/A.| UNKNOWN.