FDA Adverse Event Malfunction Summary report: N

TERUMO CDI 500 BLOOD PARAMETER MONITOR

MDR report key: 1921024 · Received November 11, 2010

Report

Report Number
1828100-2010-02066
Event Type
Malfunction
Date Received
November 11, 2010
Date of Event
October 20, 2010
Report Date
November 11, 2010
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
DRY
PMA / PMN Number
K972962
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION IN PROGRESS, BUT NOT YET CONCLUDED.

Description of Event or Problem · 1

DURING PREPARATION FOR USE OF THE DEVICE FOR CARDIOPULMONARY BYPASS PROCEDURE, THE USER REPORTED THE MONITOR GENERATED A C02 ERROR CODE. NO OTHER DETAILS REGARDING THE NATURE OF THE EVENT WERE PROVIDED. THERE WAS 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