FDA Adverse Event Malfunction Summary report: N

CARDIOVASCULAR PROCEDURE KIT

MDR report key: 2051497 · Received April 4, 2011

Report

Report Number
1212122-2011-00082
Event Type
Malfunction
Date Received
April 4, 2011
Date of Event
February 18, 2011
Report Date
March 11, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORPORATION
Product Code
OEZ
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

TERUMO DID NOT RECEIVE THE ACTUAL DEVICE AND FURTHER INVESTIGATION IS NECESSARY. TERUMO PLANS ON SUBMITTING A F/U REPORT WHEN MORE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

THE USER FACILITY REPORTED TO TERUMO CARDIOVASCULAR THAT PRIOR TO CARDIOPULMONARY BYPASS SURGERY, OUT-OF-BOX, THE DUROMETER OF TUBING WAS SOFTER THAN NORMAL. THE EVENT DID NOT CAUSE DELAY IN SURGICAL PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARDIOVASCULAR PROCEDURE KIT CONVENIENCE TUBING PACK OEZ TERUMO CARDIOVASCULAR SYSTEMS CORPORATION MN16

Patients

Seq Age Sex Outcome Treatment
1