FDA Adverse Event Malfunction Summary report: N

TERUMO CENTRIFUGAL SYSTEM

MDR report key: 1940152 · Received December 23, 2010

Report

Report Number
1828100-2010-02739
Event Type
Malfunction
Date Received
December 23, 2010
Date of Event
December 3, 2010
Report Date
December 23, 2010
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
DWA
PMA / PMN Number
K950739
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVALUATION IN PROGRESS, BUT NOT YET CONCLUDED.

Description of Event or Problem · 1

DURING ROUTINE TESTING OF THE DEVICE AT THE SERVICE CENTER, THE USER REPORTED THE BATTERY FAILED TO PROVIDE THE 1 HOUR AND 45 MINUTES OF SHORT TERM POWER AS EXPECTED. NO OTHER DETAILS REGARDING THE NATURE OF THE EVENT WERE PROVIDED. SINCE THE EVENT OCCURRED DURING ROUTINE TESTING OF THE DEVICE, THERE WAS NO PATIENT INVOLVEMENT DURING THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO CENTRIFUGAL SYSTEM CENTRIFUGAL BATTERY DWA TERUMO CARDIOVASCULAR SYSTEMS CORP. 9490

Patients

Seq Age Sex Outcome Treatment
1