FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, TYPE G PLUG

MDR report key: 19446406 · Received June 3, 2024

Report

Report Number
2249723-2024-02265
Event Type
Malfunction
Date Received
June 3, 2024
Date of Event
May 20, 2024
Report Date
February 19, 2025
Manufacturer
DATASCOPE CORP. - MAHWAH
Product Code
DSP
UDI-DI
10607567108438
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SN
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION: E1 (EVENT SITE STATE: SG, EVENT SITE POSTAL CODE: (B)(6)). A GETINGE FIELD SERVICE ENGINEER EVALUATED THE UNIT AND FOUND CABLE STUCK. IN ORDER TO FIX THE ISSUE FSE UNTANGLED CABLE REEL. TESTED CABLE FUNCTIONALITY. UNIT TESTED PASS IAW FACTORY SPECIFICATIONS. USER TO BE CAREFUL WHEN PULLING/RETRACTING CABLE. UNIT TESTED PASS AND HANDED TO USER.

Additional Manufacturer Narrative · 0

**UDI RELATED DATA QUALITY UPDATES ONLY** PROVIDING UPDATED DEVICE IDENTIFICATION INFORMATION IN ALIGNMENT WITH GUDID (D1, D2, D3, D4, G4, H4, H5).

Additional Manufacturer Narrative · 0

A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION.

Description of Event or Problem · 0

N/A.

Description of Event or Problem · 0

IT WAS REPORTED THAT BEFORE USE, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) UNIT HAD A CABLE REEL STUCK. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1825457 CARDIOSAVE HYBRID, TYPE G PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. - MAHWAH 0998-00-0800-52 10607567108438

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown