FDA Adverse Event Malfunction Summary report: N

CS300 INTRA-AORTIC BALLOON PUMP, ENGLISH, 110V

MDR report key: 22573734 · Received July 23, 2025

Report

Report Number
2249723-2025-0003126
Event Type
Malfunction
Date Received
July 23, 2025
Date of Event
July 9, 2025
Report Date
September 12, 2025
Manufacturer
DATASCOPE CORP.
Product Code
DSP
UDI-DI
10607567107882
PMA / PMN Number
K063525
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CORRECTED FIELD : G7 ,H6 ( MEDICAL DEVICE ¿ PROBLEM CODE ) UPDATED FIELD : B4, G3 , G6 , H2 , H11.

Additional Manufacturer Narrative · 0

UPDATED FIELDS: B4, G1, G3, G6, H2, H3, H6 (INVESTIGATION FINDINGS, INVESTIGATION CONCLUSION, TYPE OF INVESTIGATION), H11. A GETINGE FIELD SERVICE ENGINEER (FSE) WAS DISPATCHED TO EVALUATE THE UNIT. FSE STATES, END USER OBSERVED FIBER OPTIC SENSOR FAILURE. TESTED CS300 AND EXAMINED FAULT LOGS AND OBSERVED NO FIBER OPTIC FAILURES LOGGED. PERFORMED FIBER OPTIC TEST AND PASSED TO SPECIFICATIONS. COULD NOT DUPLICATE FAILURE. UNIT PASSED ALL FUNCTIONAL AND SAFETY TESTS PER FACTORY SPECIFICATIONS, RETURNED TO CUSTOMER. COMPLETED REPAIR SUCCESSFULLY. COMPLETED PRODUCT INSPECTION PER CUSTOMER/MANUFACTURER REQUIREMENTS.

Additional Manufacturer Narrative · 0

DUE TO CHARACTER LIMITATION, EVENT SITE FULL NAME (E1):(B)(6). A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION.

Description of Event or Problem · 0

NA.

Description of Event or Problem · 0

IT WAS REPORTED THAT CS300 INTRA-AORTIC BALLOON PUMP (IABP) HAD THE FIBER OPTIC FAILED. THERE WAS NO HARM OR INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1737887 CS300 INTRA-AORTIC BALLOON PUMP, ENGLISH, 110V SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. 0998-00-3023-53 10607567107882

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown UNKNOWN.