FDA Adverse Event
Malfunction
Summary report: N
TERUMO CENTRIFUGAL SYSTEM
MDR report key: 2171037
·
Received July 1, 2011
Report
- Report Number
- 1828100-2011-01900
- Event Type
- Malfunction
- Date Received
- July 1, 2011
- Date of Event
- June 9, 2011
- Report Date
- July 1, 2011
- Manufacturer
- TERUMO CARDIOVASCULAR SYSTEM CORP.
- Product Code
- DWA
- PMA / PMN Number
- K950739
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SC, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
EVALUATION IN PROGRESS, BUT NOT YET CONCLUDED.
Description of Event or Problem · 1
THE USER REPORTED THAT THE CABLE CONNECTOR WAS CRACKED AND THAT THE READINGS WERE BAD. NO OTHER DETAILS REGARDING THE NATURE OF THE EVENT WERE PROVIDED. THERE WERE NO REPORTED ADVERSE CONSEQUENCES TO A PT AS A RESULT OF THIS EVENT.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | TERUMO CENTRIFUGAL SYSTEM | CENTRIFUGAL CONTROL MOTOR | DWA | TERUMO CARDIOVASCULAR SYSTEM CORP. | 164267 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |