FDA Adverse Event Malfunction Summary report: N

SENSATION PLUS 8FR. 50CC IAB & ACCESSORIES (W/PRESSURE TUBES, NO STYLET)

MDR report key: 18404956 · Received December 27, 2023

Report

Report Number
2248146-2023-00737
Event Type
Malfunction
Date Received
December 27, 2023
Date of Event
December 9, 2023
Report Date
August 29, 2024
Manufacturer
DATASCOPE CORP.
Product Code
DSP
PMA / PMN Number
K133074
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL REPORTER: (B)(6). THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER SO WE ARE UNABLE TO COMPLETE AN EVALUATION. IF PROVIDED WE WILL SEND A SUPPLEMENTAL REPORT WITH OUR ADDITIONAL FINDINGS. COMPLAINT RECORD ID # 943571 H3 OTHER TEXT : DEVICE NOT RETURNED.

Additional Manufacturer Narrative · 0

THE DEVICE HAS NOT BEEN RETURNED TO THE MANUFACTURER SO WE ARE UNABLE TO COMPLETE AN EVALUATION. REFERENCE COMPLAINT: (B)(4).

Additional Manufacturer Narrative · 0

COMPLAINT RECORD ID #(B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT AFTER INSERTING THE INTRA-AORTIC BALLOON (IAB), IT WAS WORKING PROPERLY. HOWEVER, AFTER MOVING THE PATIENT FROM THE TABLE TO THE BED, THE PUMP GENERATED A FIBER OPTIC SENSOR FAILURE ALARM. THE GETINGE REPRESENTATIVE HAD THE CUSTOMER REMOVE AND REINSERT THE FIBER OPTIC SENSOR, BUT THE MESSAGE CONTINUED. IT WAS THEN RECOMMENDED THEY REMOVE THE ORANGE CABLE FROM THE PUMP, COIL IT UP AND MARK IT "BROKEN". THEY WERE THEN ABLE TO TRANSDUCE THE INNER LUMEN TO THE PUMP, LEVEL, AND ZERO IT. THE FOLLOW UP TEXTED IMAGE SHOWED A NORMAL LOOKING NON-FIBEROPTIC WAVEFORM WITH INDICES. THERE WAS NO PATIENT HARM OR ADVERSE EVENT REPORTED.

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1400751 SENSATION PLUS 8FR. 50CC IAB & ACCESSORIES (W/PRESSURE TUBES, NO STYLET) SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. 0684-00-0576-01 3000309868

Patients

Seq Age Sex Outcome Treatment
1 65 YR Male