FDA Adverse Event Malfunction Summary report: N

SYSTEM 98

MDR report key: 2072832 · Received March 31, 2011

Report

Report Number
2249723-2011-00023
Event Type
Malfunction
Date Received
March 31, 2011
Date of Event
January 29, 2011
Report Date
February 3, 2011
Manufacturer
DATASCOPE CORP.
Product Code
DSP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO ADD'L INFO REGARDING THE INCIDENT WAS PROVIDED BY MAQUET (B)(4) AT THIS TIME. DATASCOPE (B)(4) WILL FILE A F/U REPORT AS SOON AS THE INVESTIGATION INFO IS AVAILABLE.

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT WHILE THE UNIT WAS IN USE ON A PT, THE UNIT ALARMED, AND DISPLAYED A "RAPID GAS LOSS" MESSAGE. THE PT WAS SWITCHED TO ANOTHER UNIT AND THERAPY WAS CONTINUED. SEVERAL DAYS LATER, WHILE THE UNIT WAS IN USE ON A PT, THE UNIT SHUT DOWN. THE PT WAS SWITCHED TO ANOTHER UNIT AND THERAPY WAS CONTINUED. NO PT INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYSTEM 98 INTRA-AORTIC BALLOON PUMP DSP DATASCOPE CORP. SYSTEM 98

Patients

Seq Age Sex Outcome Treatment
1 UNK