FDA Adverse Event Other Summary report: N

TERUMO CDI 500 BLOOD PARAMETER MONITOR

MDR report key: 1734026 · Received June 18, 2010

Report

Report Number
1828100-2010-00616
Event Type
Other
Date Received
June 18, 2010
Date of Event
May 27, 2010
Report Date
June 18, 2010
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
DRY
PMA / PMN Number
K972962
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVAL IN PROGRESS, BUT NOT YET COMPLETED.

Description of Event or Problem · 1

DURING USE OF THE DEVICE FOR A CARDIOPULMONARY BYPASS PROCEDURE, THE USER REPORTED THE ARTERIAL MODULE FAILED TO FUNCTION. THE USER REPORTED THE SURGICAL PROCEDURE WAS COMPLETED SUCCESSFULLY AND THERE WERE NO REPORTED ADVERSE CONSEQUENCES TO A PT AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO CDI 500 BLOOD PARAMETER MONITOR ON LINE BLOOD GAS MONITOR DRY TERUMO CARDIOVASCULAR SYSTEMS CORP. 500AHCT

Patients

Seq Age Sex Outcome Treatment
1