FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, TYPE B PLUG

MDR report key: 18754235 · Received February 21, 2024

Report

Report Number
2249723-2024-00761
Event Type
Malfunction
Date Received
February 21, 2024
Date of Event
February 13, 2024
Report Date
November 22, 2024
Manufacturer
DATASCOPE CORP. - MAHWAH
Product Code
DSP
UDI-DI
10607567108391
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION. E1 INITIAL REPORTER WAS SHORTENED DUE TO CHARACTER LIMITATIONS. THE COMPLETE NAME IS (B)(6).

Additional Manufacturer Narrative · 0

A GETINGE FIELD SERVICE ENGINEER (FSE) SAYS UNIT SURFACED A FIBER OPTIC SENSOR FAILURE PROMPT WHILE ON PATIENT. UNIT NEVER STOPPED WORKING OTHERWISE, AND FULLY FUNCTIONAL. UNIT JUST FAILED TO DISPLAY BLOOD PRESSURE WAVE FORM VIA THE FIBER OPTIC. FSE WAS UNABLE TO REPLICATE USER COMPLAINT. SUCCESSFULLY COMPLETED A SIMULATED TREATMENT ON UNIT WITH TESTING CATHETER AND TRAINER WITHOUT ISSUE UPON INITIALLY TESTING UNIT. SUCCESSFULLY COMPLETED A FUNCTION CHECK ON THE FIBER OPTIC WHILE RUNNING WITH TRAINER AND CATHETER SUCCESSFULLY OBTAINING BLOOD PRESSURE WAVEFORM AND VALUES. UNIT DID RECOGNIZED FIBER OPTIC WHEN CONNECTED, AND FIBER OPTIC CONNECTOR INTACT AND IN GOOD CONDITION. IDENTIFIED A FIBER OPTIC FAILURE IN THE LOGS. REPLACED FIBER OPTIC MODULE AND CABLE AS A PRECAUTION. POST REPLACEMENT, SUCCESSFULLY COMPLETED FULL SYSTEM CHECK OUT WITHOUT EXCEPTION. UNIT CALIBRATED AND PASSED ALL FUNCTIONAL AND SAFETY TESTS PER FACTORY SPECIFICATIONS AND RETURNED TO CUSTOMER. THE DEFECTIVE COMPONENTS WERE RECEIVED FOR FURTHER INVESTIGATION. THE FAILURE ANALYSIS AND TESTING DEPT. RECEIVED THE FOLLOWING PARTS ASSOCIATED WITH THIS COMPLAINT: PN 0997-00-1169 SN (B)(6)AND PN 0012-00-1808. THE FAT PERFORMED A VISUAL INSPECTION AND FOUND THE PART TO BE IN GOOD CONDITION. THE FAT INSTALLED PN 0997-00-1169 IN CARDIOSAVE TEST FIXTURE AND TESTED THE PART TO FACTORY SPECIFICATIONS PER THE CARDIOSAVE SERVICE MANUAL. NO ISSUE CONFIRMED. THE FAT INSTALLED PN 0012-00-1808 IN CARDIOSAVE TEST FIXTURE AND TESTED THE PART TO FACTORY SPECIFICATIONS PER THE CARDIOSAVE SERVICE MANUAL. NO ISSUE CONFIRMED SENT THE BOARDS FROM PN 0997-00-1169 TO THE RESPECTIVE SUPPLIER PER PROCEDURE. RETAINING PN 0012-00-1808 IN THE FAILURE ANALYSIS AND TESTING DEPARTMENT PER PROCEDURE. THE FOLLOWING WAS INPUT BY TECHNICIAN OF THE MAQUET FAILURE ANALYSIS AND TESTING DEPT. (FAT). THE FAT RECEIVED THE FAILURE ANALYSIS FROM THE SUPPLIER FOR PN 0992-00-1017 SN (B)(6). SUPPLIER STATED THE ROOT CAUSE IS THE OPTICAL BLOC BEING BAD BUT DID NOT STATE HOW THIS WAS POSSIBLE. RETAINING THE PART IN THE FAILURE ANALYSIS AND TESTING DEPARTMENT PER PROCEDURE. THE FOLLOWING INVESTIGATION WAS PERFORMED BY TECHNICIAN OF THE MAQUET FAILURE ANALYSIS AND TESTING DEPT. (FAT). THE FAT DEPT. RECEIVED PART NUMBER 0670-00-1160 REV A, FIBER OPTIC INTERFACE MODULE BOARD SERIAL NUMBER (B)(6) FROM THE SUPPLIER. SUPPLIER INVESTIGATION: PERFORMED VISUAL CHECK AND NO ABNORMALITY FOUND. BOARD WAS RE-TESTED AT FCT AND PASSED. RESULT AT INSPECTION AND TEST IS GOOD AND NO ABNORMALITIES WAS DETECTED. BOARD WAS NDF. RETAINING THIS BOARD IN THE FAT DEPT. PER PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USE ON A PATIENT, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) HAD A FIBER OPTIC SENSOR MODULE FAILURE. NO PATIENT HARM OR INJURY REPORTED.

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1575905 CARDIOSAVE HYBRID, TYPE B PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. - MAHWAH 0998-00-0800-53 10607567108391

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown UNKNOWN.