FDA Adverse Event Malfunction Summary report: N

TUBING SETS

MDR report key: 21948520 · Received May 2, 2025

Report

Report Number
8010762-2025-0000198
Event Type
Malfunction
Date Received
May 2, 2025
Date of Event
April 18, 2025
Report Date
July 2, 2025
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
DWE
PMA / PMN Number
K053025
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

IT WAS REPORTED THAT THE PEDIATRIC OXYGENATOR WAS FOUND NON-FUNCTIONAL AT THE START OF CPB. THE OXYGENATOR WAS REPLACED INTRAOPERATIVELY WITH ANOTHER UNIT FROM THE SAME BATCH WITHOUT ANY CLINICAL CONSEQUENCE. NO HARM OR DEATH TO ANY PERSON WAS REPORTED. FURTHER INFORMATION WAS RECEIVED ON 2025-06-23, THAT STATES THERE COULD NOT BE FOUND ANY FAILURE WITH THE OXYGEN SUPPLY AS THE FAILURE WAS RESOLVED WITH THE CHANGE OF OXYGENATOR. THE ONLY AVAILABLE INFORMATION IS A DROP ON PAO2. THE PRODUCT WAS INVESTIGATED AT MAQUET CARDIOPULMONARY GMBH LABORATORY ON (B)(6) 2025. TIGHTNESS TEST WAS PERFORMED AND PASSED FOR THE BLOOD SIDE, WATER SIDE, AND GAS SIDE. ADDITIONALLY, THE FLOW TEST WAS PASSED. FURTHER, A VISUAL INSPECTION WAS PERFORMED AND NO DEFORMATION WAS OBSERVED HOWEVER IT SHOWS BLOOD CLOTS INSIDE OXYGENATOR. BASED ON THE LABORATORY INVESTIGATION RESULTS, OXYGENATOR WAS FOUND AS FUNCTIONAL. THEREFORE, COMPLAINT COULD NOT BE CONFIRMED. BASED ON THE INVESTIGATION RESULTS, THERE COULD NOT BE FOUND ANY FAILURE WITH THE RECEIVED OXYGENATOR. IT IS IMPOSSIBLE TO DETERMINE THE EXACT CAUSE OF THE REPORTED FAILURE HOWEVER POSSIBLE CAUSES ARE: PROBLEM WITH OXYGEN SUPPLY SYSTEM, USER ERROR, CLOT FORMATION THESE CAUSES COULD NOT BE CONFIRMED. THE PRODUCTION HISTORY RECORD (DHR) OF THE AFFECTED QUADROX-I NEO WITH LOT # 3000409093 WAS REVIEWED ON 2025-05-16. ACCORDING TO THE DHR RESULTS, THE PRODUCT QUADROX-I NEO PASSED THE DEFINED MANUFACTURING AND FINAL RELEASE SPECIFICATIONS. THERE IS NO INDICATION ON MANUFACTURING ISSUES. THUS, PRODUCTION RELATED INFLUENCES ARE UNLIKELY. FURTHER, THE LOT NUMBER OF THE AFFECTED CUSTOM TUBING SET 'HQV 140701#PACK STANDARD VKMO 11000' WAS NOT PROVIDED BY CUSTOMER. HOWEVER, THE FOLLOWING BATCH NUMBERS WERE FOUND VIA SAP THAT ARE SOLD TO CHU BORDEAUX - HOPITAL PELLEGRIN WITH THE CONSUMED BATCH OF OXYGENATOR: #3000443403, #3000422280 AND #3000414709. THE PRODUCTION HISTORY RECORDS (DHR) OF THE AFFECTED HQV 140701#PACK STANDARD VKMO 11000 WITH LOTS #3000443403, #3000422280 AND #3000414709 WERE REVIEWED ON 2025-07-05. ACCORDING TO THE DHR RESULT, THE PRODUCT HQV 140701#PACK STANDARD VKMO 11000 PASSED THE DEFINED MANUFACTURING AND FINAL RELEASE SPECIFICATIONS. THERE IS NO INDICATION ON MANUFACTURING ISSUES. THUS, PRODUCTION RELATED INFLUENCES ARE UNLIKELY. THE OCCURRENCE RATE WAS CALCULATED FOR THE REPORTED FAILURE AND PRODUCT 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 SAMPLE WAS INVESTIGATED AT MAQUET CARDIOPULMONARY GMBH LABORATORY ON (B)(6) 2025. TIGHTNESS TEST WAS PERFORMED AND PASSED FOR THE BLOOD SIDE, WATER SIDE, AND GAS SIDE. ADDITIONALLY, THE FLOW TEST WAS PASSED. FURTHER, A VISUAL INSPECTION WAS PERFORMED AND NO DEFORMATION WAS OBSERVED HOWEVER IT SHOWS BLOOD CLOTS INSIDE OXYGENATOR. BASED ON THE LABORATORY INVESTIGATION RESULTS, OXYGENATOR WAS FOUND AS FUNCTIONAL. A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN FURTHER INFORMATION BECOMES AVAILABLE.

Additional Manufacturer Narrative · 0

A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN FURTHER INFORMATION BECOMES AVAILABLE.

Description of Event or Problem · 0

COMPLAINT # (B)(4).

Description of Event or Problem · 0

(B)(4).

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PEDIATRIC OXYGENATOR WAS FOUND NON-FUNCTIONAL AT THE START OF CPB. THE OXYGENATOR WAS REPLACED INTRAOPERATIVELY WITH ANOTHER UNIT FROM THE SAME BATCH WITHOUT ANY CLINICAL CONSEQUENCE. NO HARM OR DEATH TO ANY PERSON WAS REPORTED. SINCE THE FAILURE OCCURRED DURING PATIENT USE, THE COMPLAINT IS REPORTABLE. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
192483 TUBING SETS TUBING, PUMP, CARDIOPULMONARY BYPASS DWE MAQUET CARDIOPULMONARY GMBH HQV 140701 N/I

Patients

Seq Age Sex Outcome Treatment
1 22 MO Unknown Other