FDA Adverse Event Malfunction Summary report: N

T.W. POWER SUPPLY

MDR report key: 20762470 · Received November 22, 2024

Report

Report Number
2242352-2024-0001282
Event Type
Malfunction
Date Received
November 22, 2024
Report Date
January 17, 2025
Manufacturer
MAQUET CARDIOVASCULAR LLC
Product Code
GEI
UDI-DI
00607567700826
PMA / PMN Number
K052274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

TRACKWISE ID# (B)(4). COMPLAINT BEING CANCELLED DUE TO ADDITIONAL INFORMATION RECEIVED INDICATES THERE WERE NO DEFECTS WITH THE REPORTED DEVICE. PER THE COMPLAINT HANDLING PROCEDURE THE INFORMATION RECEIVED DOES NOT MEET THE CRITERIA OF A COMPLAINT. PLEASE REDACT MFG REPORT NUMBER 2242352-2024-0001282.

Additional Manufacturer Narrative · 0

TRACKWISE ID# (B)(4). THE DEVICE HAS NOT YET BEEN RETURNED TO MAQUET CARDIAC SURGERY FOR EVALUATION. WE ARE FOLLOWING UP WITH THE CUSTOMER FOR THE RETURN OF THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED.

Description of Event or Problem · 0

COMPLAINT BEING CANCELLED DUE TO ADDITIONAL INFORMATION RECEIVED INDICATES THERE WERE NO DEFECTS WITH THE REPORTED DEVICE. PER THE COMPLAINT HANDLING PROCEDURE THE INFORMATION RECEIVED DOES NOT MEET THE CRITERIA OF A COMPLAINT. PLEASE REDACT MFG REPORT NUMBER 2242352-2024-0001282.

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT T.W. POWER SUPPLY WAS DEFECTIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2599212 T.W. POWER SUPPLY ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI MAQUET CARDIOVASCULAR LLC VH-3010 00607567700826

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown