FDA Adverse Event Malfunction Summary report: N

TERUMO ADVANCED PERFUSION SYSTEM 1

MDR report key: 2060899 · Received March 14, 2011

Report

Report Number
1828100-2011-00627
Event Type
Malfunction
Date Received
March 14, 2011
Date of Event
February 18, 2011
Report Date
March 14, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
DTQ
PMA / PMN Number
K022947
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

EVAL IN PROGRESS, BUT NOT YET CONCLUDED.

Description of Event or Problem · 1

DURING PREVENTATIVE MAINTENANCE OF THE DEVICE, THE FIELD SVC REP REPORTED THAT THE HEART LUNG CONSOLE FAILED TO POWER UP USING BATTERY POWER, EVEN AFTER SEVERAL HOURS OF CHARGING THE CONSOLE. SINCE THE EVENT OCCURRED DURING PREVENTATIVE MAINTENANCE OF THE DEVICE, THERE WAS NO PT INVOLVEMENT DURING THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO ADVANCED PERFUSION SYSTEM 1 HEART LUNG CONSOLE DTQ TERUMO CARDIOVASCULAR SYSTEMS CORP. 801763

Patients

Seq Age Sex Outcome Treatment
1