FDA Adverse Event Malfunction Summary report: N

HEART LUNG MACHINE

MDR report key: 21089170 · Received January 7, 2025

Report

Report Number
8010762-2025-0000002
Event Type
Malfunction
Date Received
January 7, 2025
Date of Event
December 24, 2024
Report Date
January 21, 2025
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
KFM
PMA / PMN Number
K991864
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE EVENT OCCURRED IN CHINA. IT WAS REPORTED THAT THE ERROR MESSAGE ¿COM ERROR¿ WAS DISPLAYED ON THE ROTFLOW CONSOLE DURING USE. THE DEVICE WAS SHUT DOWN AND THEN RESTARTED WHICH DID NOT SOLVE THE PROBLEM. THE CUSTOMER IMMEDIATELY REPLACED THE DEVICE WITH ANOTHER DEVICE. NO HARM TO ANY PERSON HAS BEEN REPORTED. DUE TO THE REPORTED EXCHANGE A REPORT IS REQUIRED. THE PATIENT DATA (SUCH AS SEX, WEIGHT AND AGE AT THE TIME OF EVENT) WAS REQUESTED ON 2024-12-24 BUT THE CUSTOMER NOT PROVIDED ANY DETAILS. ACCORDING TO THE SSU (SALES AND SERVICE UNIT) DATED ON 2025-01-19 THE MCP00702707# FLOW MEASURE BOARD FOR RFC (ARTICLE NUMBER: (B)(4) HAS BEEN REPLACED. A SIMILAR COMPLAINT WAS INVESTIGATED FOR THE REPORTED FAILURE IN THE GETINGE LIFE-CYCLE-ENGINEERING (LCE). THE REPORTED FAILURE WAS CAUSED MOST PROBABLY BY AN DEFECTIVE BUS TRANSCEIVER (IC3) ON THE FLOW MEASUREMENT BOARD. BASED ON THE INVESTIGATION RESULTS THE REPORTED FAILURE "COM ERROR" COULD BE CONFIRMED. THE REVIEW OF THE NON-CONFORMITIES HAS BEEN PERFORMED ON 2025-01-21 FOR THE PERIOD OF 2020-10-14 TO 2024-12-24. IT DOES NOT SHOW ANY NON-CONFORMITY IN REGARD TO THE REPORTED PRODUCT AND FAILURE. THERE IS NO INDICATION THAT MANUFACTURING ISSUES OCCURRED DURING THIS TIME, THUS PRODUCTION RELATED INFLUENCES ARE UNLIKELY. THE ROTAFLOW CONSOLE WAS PRODUCED IN 2020-10-14. IN ADDITION, A REVIEW FOR POTENTIAL FIELD ACTIONS AND CAPAS RELATED TO THE FAILURE AND PRODUCT IN THIS COMPLAINT WAS PERFORMED. THIS COMPLAINT IS NOT IN SCOPE OF ANY ONGOING FIELD ACTIONS AND/OR CAPAS. FOR THE AFFECTED SERIAL NUMBER WITHIN THE TIMEFRAME OF THE SEARCH NO ADDITIONAL COMPLAINT WAS FOUND FOR THE SAME ISSUE. THE CUSTOMER WILL BE INFORMED ABOUT THE RESULTS BY THE GETINGE SALES AND SERVICE UNIT. THE OCCURRENCE RATE WAS CALCULATED FOR THE REPORTED ISSUE AND IT WAS DETERMINED THAT THIS IS NOT A SYSTEMIC ISSUE. THEREFORE, NO REMEDIAL ACTION IS REQUIRED. THE OCCURRENCE RATE RELATED TO THE REPORTED ISSUE IS CURRENTLY BEING MONITORED AS PART OF MAQUET CARDIOPULMONARY¿S TRENDING PROGRAM AND ADDITIONAL INVESTIGATIONS OR CORRECTIONS WILL BE IMPLEMENTED IN CASE OF ADVERSE TRENDING.

Additional Manufacturer Narrative · 0

THE INVESTIGATION IS ONGOING. FURTHER INFORMATION HAS BEEN REQUESTED BUT HAS NOT YET BEEN RECEIVED. A FOLLOW UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. THIS EVENT OCCURRED ON THE CHINESE MARKET ON A SIGNIFICANTLY SIMILAR DEVICE TO ROTAFLOW, WHICH IS SOLD IN THE US. FOR D4 UNIQUE IDENTIFIER (UDI)# (B)4), PRIMARY DI NUMBER HAS BEEN USED FOR BASE UNIT, ROTAFLOW WITH CATALOG NUMBER 701046405. PROVIDED D4 SERIAL NUMBER AND H4 DEVICE MANUFACTURER DATE CORRESPOND TO DEVICE INVOLVED IN THE EVENT, NOT AVAILABLE IN US.

Description of Event or Problem · 0

COMPLAINT ID: (B)(4).

Description of Event or Problem · 0

THE EVENT OCCURRED IN CHINA. IT WAS REPORTED THAT THE ERROR MESSAGE ¿COM ERROR¿ WAS DISPLAYED ON THE ROTFLOW CONSOLE DURING USE. THE DEVICE WAS SHUT DOWN AND THEN RESTARTED WHICH DID NOT SOLVE THE PROBLEM. THE CUSTOMER IMMEDIATELY REPLACED THE DEVICE WITH ANOTHER DEVICE. NO HARM TO ANY PERSON HAS BEEN REPORTED. DUE TO THE REPORTED EXCHANGE A REPORT IS REQUIRED. COMPLAINT ID: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1347914 HEART LUNG MACHINE PUMP, BLOOD, CARDIOPULMONARY BYPASS, NON-ROLLER TYPE KFM MAQUET CARDIOPULMONARY GMBH MCP00706291#ROTAFLOW CHINESE ZH-PLUG

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention