FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, 3.1 EDITION

MDR report key: 19382726 · Received May 23, 2024

Report

Report Number
2249723-2024-02142
Event Type
Malfunction
Date Received
May 23, 2024
Date of Event
May 15, 2024
Report Date
February 10, 2025
Manufacturer
DATASCOPE CORP.
Product Code
DSP
UDI-DI
10607567113432
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

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.

Additional Manufacturer Narrative · 0

CORRECTED DATA: B5, E1 (CITY AND SITE NAME). UPDATED DATA: B4, E1(ADDRESS), G3, G6, H2, H10, H11.

Additional Manufacturer Narrative · 0

UPDATED FIELDS: B4,D1,D4 (VERSION OR MODEL #, CATALOG#), D9, G3, G6, H2, H3, H4, H6(TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, COMPONENT CODE, INVESTIGATION CONCLUSION), H10. ADDITIONAL CONTACT DETAILS: EVENT SITE POSTAL CODE - 2240001. IT WAS REPORTED THAT CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) WITH BALLOON RUPTURE. A GETINGE FIELD SERVICE ENGINEER EVALUATED, NO BLOOD WAS FOUND INSIDE. THE OPERATION CHECK HAS BEEN CARRIED OUT. THE EQUIPMENT IS IN GOOD CONDITION. OCCURS DURING CLINICAL USE. PATIENT INVOLVED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USE ON A PATIENT, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) WAS POLLUTED BY BLOOD. THERE WAS NO IMPACTS ON PATIENT.

Description of Event or Problem · 0

N/A.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING USE ON A PATIENT, THE BALLOON RUPTURED AND THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) WAS POLLUTED BY BLOOD. THERE WAS NO IMPACTS ON PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
501076 CARDIOSAVE HYBRID, 3.1 EDITION SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. 0998-00-0800-65 10607567113432

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown UNKNOWN.