FDA Adverse Event
Malfunction
Summary report: N
TERUMO PERFUSION SYSTEM 8000
MDR report key: 2100486
·
Received May 13, 2011
Report
- Report Number
- 1828100-2011-01306
- Event Type
- Malfunction
- Date Received
- May 13, 2011
- Date of Event
- April 20, 2011
- Report Date
- May 13, 2011
- Manufacturer
- TERUMO CARDIOVASCULAR SYSTEMS CORP.
- Product Code
- JOR
- PMA / PMN Number
- K915183
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
DURING ROUTINE TESTING OF THE DEVICE AT THE SERVICE CENTER, THE USER REPORTED THAT THE CARDIOPLEGIA AND ARTERIAL PUMPS WOULD OPERATE ON AC, BUT NOT BATTERY POWER. THE USER REPORTED THERE WAS AN ISSUE WITH THE BASE POWER DISTRIBUTION BOARD. SINCE THE EVENT OCCURRED DURING ROUTINE TESTING, THERE WAS NO PT INVOLVEMENT DURING THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | TERUMO PERFUSION SYSTEM 8000 | ROLLER PUMP | JOR | TERUMO CARDIOVASCULAR SYSTEMS CORP. | 16401 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |