FDA Adverse Event
Malfunction
Summary report: N
TERUMO PERFUSION SYSTEM 8000
MDR report key: 2180826
·
Received July 1, 2011
Report
- Report Number
- 1828100-2011-01846
- Event Type
- Malfunction
- Date Received
- July 1, 2011
- Date of Event
- June 8, 2011
- Report Date
- July 1, 2011
- Manufacturer
- TERUMO CARDIOVASCULAR SYSTEMS CORP.
- Product Code
- JOR
- PMA / PMN Number
- K915183
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MO, US
- Reporter Occupation
- NOT APPLICABLE
Narratives
Description of Event or Problem · 1
DURING PREVENTATIVE MAINTENANCE OF THE DEVICE, THE USER REPORTED THAT A MOTOR NOISE OCCURRED AT LOW REVOLUTIONS PER MINUTE. SINCE THE EVENT OCCURRED DURING PREVENTATIVE MAINTENANCE, THERE WAS NO PATIENT 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. | 16402 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |