FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, TYPE G PLUG

MDR report key: 18161255 · Received November 17, 2023

Report

Report Number
2249723-2023-04926
Event Type
Malfunction
Date Received
November 17, 2023
Date of Event
November 9, 2023
Report Date
September 20, 2024
Manufacturer
DATASCOPE CORP.
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

EVENT SITE STATE AND POSTAL CODE: (B)(6). IT WAS REPORTED THAT CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) NETWORK CONNECTIVITY TEST FOR D.00. A GETINGE FIELD SERVICE ENGINEER EVALUATED AFTER THE D.00 UPGRADE, THE NETWORK EXPORT SETTINGS WERE RESET AND THE CARDIOSAVE IS UNABLE TO EXPORT DATA TO THE PHILIPS INTELLIVUE EC10 AND EPIC EMR SYSTEM. ADJUSTED THE SETTINGS AND UNIT TESTED TO BE OK. NO PATIENT INVOLVEMENT.

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

**UDI RELATED DATA QUALITY UPDATES ONLY** PROVIDING UPDATED DEVICE IDENTIFICATION INFORMATION IN ALIGNMENT WITH GUDID.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AFTER THE FSCA D.00 UPDATE, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) UNIT'S NETWORK SETTINGS WERE RESET AND HAVE TO BE READJUSTED FOR IT TO CONNECT TO THE PHILIPS INTELLIVUE MONITORING SYSTEM AND EPIC EMR SYSTEM. THERE WAS NO PATIENT INVOLVEMENT REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING AFTER THE FSCA D.00 UPDATE, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) UNIT'S NETWORK SETTINGS WERE RESET AND HAVE TO BE READJUSTED FOR IT TO CONNECT TO THE PHILIPS INTELLIVUE MONITORING SYSTEM AND EPIC EMR SYSTEM.

Description of Event or Problem · 0

N/A.

Description of Event or Problem · 0

N/A

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1745301 CARDIOSAVE HYBRID, TYPE G PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. 0998-00-0800-52 10607567108438

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown