FDA Adverse Event Malfunction Summary report: N

TERUMO CDI 500 BLOOD PARAMETER MONITOR

MDR report key: 2241018 · Received August 17, 2011

Report

Report Number
1828100-2011-02473
Event Type
Malfunction
Date Received
August 17, 2011
Date of Event
July 21, 2011
Report Date
August 17, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEM CORP.
Product Code
DRY
PMA / PMN Number
K972962
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

EVALUATION IN PROGRESS, BUT NOT YET CONCLUDED.

Description of Event or Problem · 1

DURING PREPARATION OF THE DEVICE FOR CARDIOPULMONARY BYPASS PROCEDURE, THE USER REPORTED THAT THE HEMATOCRIT SATURATION PROBE WAS BROKEN. AS A RESULT, AN ALTERNATE DEVICE WAS EMPLOYED. THE USER REPORTED THE SURGICAL PROCEDURE WAS COMPLETED SUCCESSFULLY, AND THERE WERE NO ADVERSE CONSEQUENCES TO THE PATIENT AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO CDI 500 BLOOD PARAMETER MONITOR ON LINE BLOOD GAS MONITOR DRY TERUMO CARDIOVASCULAR SYSTEM CORP. 500AHCT

Patients

Seq Age Sex Outcome Treatment
1