FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID W/ E/F PLUG

MDR report key: 16090716 · Received January 3, 2023

Report

Report Number
2249723-2023-00025
Event Type
Malfunction
Date Received
January 3, 2023
Date of Event
December 15, 2022
Report Date
March 16, 2023
Manufacturer
DATASCOPE CORP. - MAHWAH
Product Code
DSP
UDI-DI
10607567108414
PMA / PMN Number
K112372
Removal / Correction Number
2249723-01/24/2023-004-C
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

A GETINGE FIELD SERVICE ENGINEER (FSE) WAS DISPATCHED TO INVESTIGATE THE ISSUE. THE FSE FOUND AN O-RING AND CONNECTOR BREAKAGE. SO, IN ORDER TO SOLVE THE ISSUE, THE FSE REPLACED THE O-RING (0354-00-0208) AND THE QUICK DISCONNECT FITTING (0103-00-0686). THE FSE THEN PERFORMED SENSOR CALIBRATION, FUNCTIONAL TESTS, AND THE UNIT WAS THEN CLEARED FOR CLINICAL USE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING STARTUP, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) UNIT IS LEAKING HELIUM. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) UNIT IS LEAKING HELIUM. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
132454 CARDIOSAVE HYBRID W/ E/F PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. - MAHWAH 0998-00-0800-55 10607567108414

Patients

Seq Age Sex Outcome Treatment
1 Unknown