FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID TYPE D PLUG

MDR report key: 22639727 · Received July 28, 2025

Report

Report Number
2249723-2025-0003213
Event Type
Malfunction
Date Received
July 28, 2025
Date of Event
July 14, 2025
Report Date
April 2, 2026
Manufacturer
DATASCOPE CORP.
Product Code
DSP
UDI-DI
10607567109008
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

UPDATED FIELDS: B4, D9, G3, G6, H2, H3, H6 (TYPE OF INVESTIGATION, INVESTIGATION FINDINGS, COMPONENT CODES, INVESTIGATION CONCLUSIONS), H11. THE FSE CHECKED THE DEVICE AND CONFIRMED THE ABOVE ISSUE. VERIFIED MAINS SUPPLY AND BATTERIES ARE OK. CHECKED THE SERVICE DIAGNOSTICS AND FOUND ERROR OF PMB BOARD. RESET THE CONNECTIONS BETWEEN POWER MANAGEMENT BOARD & EXECUTIVE PROCESSOR BOARD AND THEIR MOUNTING CONNECTORS BUT STILL PROBLEM PERSIST. REQUIRED PMB BOARD FOR FURTHER TESTING. REQUIRED SPARE: POWER MANAGEMENT BOARD. THE FINAL REPAIR IS NOT CONDUCTED YET.

Additional Manufacturer Narrative · 0

UPDATED FIELD ; B4 , G3 , G6 , H2 , H11 , D9 , H6 ( TYPE OF INVESTIGATION ). A GETINGE FIELD SERVICE ENGINEER (FSE) WAS DISPATCHED TO EVALUATE THE UNIT. THE FSE CHECKED THE DEVICE AND CONFIRMED THE ABOVE ISSUE. VERIFIED MAIN SUPPLY AND BATTERIES ARE OK. CHECKED THE SERVICE DIAGNOSTICS AND FOUND ERROR OF PMB BOARD. RESET THE CONNECTIONS BETWEEN POWER MANAGEMENT BOARD & EXECUTIVE PROCESSOR BOARD AND THEIR MOUNTING CONNECTORS BUT STILL PROBLEM PERSIST. A RETURN VISIT FOUND BURN TRACES ON THE SOLENOID CONTROL BOARD. BOTH THE POWER MANAGEMENT BOARD (0670-00-1162) AND THE SOLENOID CONTROL BOARD (0670-00-1161) WERE REPLACED. THE UNIT BOOTED UP SUCCESSFULLY AND REQUIRE BATTERY MAINTENANCE TEST, THE TEST PASSED AS WELL. DEVICE PASSED THE PERFORMANCE AND SAFETY CHECKS ACCORDING TO FACTORY SPECIFICATIONS. THE FAILURE ANALYSIS AND TESTING DEPT RECEIVED THE FOLLOWING PARTS ASSOCIATED WITH THIS COMPLAINT. PART NUMBER 0670 00 1161 PCB SOLENOID CONTROL SERIAL NUMBER (B)(6). PART NUMBER 0670 00 1162 PCB POWER MANAGEMENT ROHS SERIAL NUMBER (B)(6). THESE PARTS WERE RECEIVED WITH A REPORTED UNIT FAILURE OF NOT BOOTING UP. THE FAILURE ANALYSIS AND TESTING DEPT PERFORMED A VISUAL INSPECTION AND FOUND PART NUMBER 0670 00 1162 PCB POWER MANAGEMENT ROHS SERIAL NUMBER (B)(6) TO BE IN GOOD CONDITION. PART NUMBER 0670 00 1161 PCB SOLENOID CONTROL SERIAL NUMBER (B)(6) HAS A SHORTED COMPONENT C12. PLEASE SEE ATTACHMENT. DUE TO THE SHORTED COMPONENT, THE FAT DEPT CANNOT INVESTIGATE THIS BOARD ANY FURTHER. PART NUMBER 0670 00 1162 PCB POWER MANAGEMENT ROHS SERIAL NUMBER (B)(6) WAS FOUND IN GOOD CONDITION. THE FAILURE ANALYSIS AND TESTING DEPT INSTALLED PART NUMBER 0670 00 1162 PCB POWER MANAGEMENT ROHS SERIAL NUMBER (B)(6) INTO THE CARDIOSAVE TEST FIXTURE SERIAL NUMBER (B)(6) AND TESTED THE BOARD TO FACTORY SPECIFICATIONS PER PROCEDURE NUMBER 0002 07 D016 REVISION F AND THE CARDIOSAVE SERVICE MANUAL PART NUMBER 0070 00 0639 REVISION R. THE FAT DEPT WAS ABLE TO REPLICATE THE COMPLAINT OF THE UNIT NOT BOOTING UP. THE BOARD FAILED TESTING. SENDING PART NUMBER 0670 00 1162 PCB POWER MANAGEMENT ROHS SERIAL NUMBER (B)(6) TO THE SUPPLIER PER PROCEDURE NUMBER 0002 07 D008 REV AU. RETAINING PART NUMBER 0670 00 1161 PCB SOLENOID CONTROL SERIAL NUMBER (B)(6) IN THE FAT DEPT PER PROCEDURE NUMBER 0002 07 D008 REV AU. THE FOLLOWING WAS SUBMITTED BY (B)(4) TECHNICIAN OF THE MAQUET FAILURE ANALYSIS AND TESTING DEPT, FAT, WAYNE NJ, AR, 31 MARCH 2026. FAILURE ANALYSIS RECEIVED FROM THE SUPPLIER FOR PART NUMBER 0670 00 1162. PLEASE SEE ATTACHMENT. THEY STATED: 1 PERFORM VISUAL CHECK RESULT NO ABNORMALITY FOUND 2 BOARD WAS RE TESTED AT FCT RESULT FAILED STEP 8 9 13 3 BCP SLOT 2 DCIN BAT BATDIS AT TP67 3 PERFORM TROUBLESHOOTING ON THE BOARD FOUND Q31 Q33 Q35 DEFECTIVE ROOT CAUSE FOR THIS PART IS DUE TO DEFECTIVE COMPONENTS. RETAINING THE PART IN THE FAILURE ANALYSIS AND TESTING DEPARTMENT PER PROCEDURE NUMBER 0002 07 D008 REV.

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

UPDATED DATA: B4, G3, G6, H1, H2, H11 CORRECTED DATA: H6 (INVESTIGATION CONCLUSIONS ).

Description of Event or Problem · 0

N/A.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING ROUTINE CHECK BY END USER, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) MACHINE IS NOT BOOTING UP. THERE WAS NO PATIENT INVOLVEMENT REPORTED.

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1622652 CARDIOSAVE HYBRID TYPE D PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. 0998-00-0800-33 10607567109008

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown