FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE HYBRID, TYPE B PLUG

MDR report key: 23302427 · Received October 15, 2025

Report

Report Number
2249723-2025-0004318
Event Type
Malfunction
Date Received
October 15, 2025
Date of Event
September 24, 2025
Report Date
December 20, 2025
Manufacturer
DATASCOPE CORP.
Product Code
DSP
UDI-DI
10607567108391
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
BIOMEDICAL ENGINEER
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

DUE TO CHARACTER LIMITATION IN E1 FOR EVENT SITE NAME, EVENT SITE NAME - (B)(6) MEDICAL CENTER. A SUPPLEMENTAL REPORT WILL BE SUBMITTED UPON COMPLETION OF OUR INVESTIGATION.

Additional Manufacturer Narrative · 0

UPDATED DATA: B4, G3, G6, H1, D9, H2, H11, H3, H6 (TYPE OF INVESTIGATION, MEDICAL DEVICE ¿ PROBLEM CODE INVESTIGATION FINDINGS, COMPONENT CODES, INVESTIGATION CONCLUSIONS), E1 (INITIAL REP NAME). CORRECTED FIELD: MANUFACTURE DATE: NOT AVAILABLE. FULL INITIAL REPORTER NAME: (B)(6). THERE WAS NO PATIENT INVOLVED. A GETINGE FIELD SERVICE ENGINEER (FSE) EVALUATED THE UNIT AND VERIFIED IN LOGS ERROR CODE RELATED TO POWER MANAGEMENT PCB. FSE REPLACED THE POWER MANAGEMENT BOARD (0670-00-1162) AS A PRECAUTION AND PERFORMED TEST. ALL FUNCTIONAL AND SAFETY CHECKS ARE MEET TO FACTORY SPECIFICATIONS PERFORMED AND PASSED.THE FOLLOWING INVESTIGATION WAS PERFORMED BY CARL FAMULARE, TECHNICIAN OF THE MAQUET FAILURE ANALYSIS AND TESTING DEPT. (FAT) (B)(6) (B)(6) 2025. THE FAILURE ANALYSIS AND TESTING DEPT. RECEIVED PART NUMBER 0670-00-1162 SERIAL NUMBER (B)(6) WITH A REPORTED UNIT FAILURE OF DEVICE FAILED TO BOOT UP, AND CODE 139. THE FAILURE ANALYSIS AND TESTING DEPT. PERFORMED A VISUAL INSPECTION AND FOUND THE PART TO BE 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 CARDIOSAVE BOOTED UP WITH NO PROBLEM FOUND. AFTER A RUN-TIME OF 1.5 HOURS, THE FAT DID NOT OBSERVE ERROR CODE 139. THE FAT DEPT. COULD NOT REPLICATE THE UNIT NOT BOOTING UP AND COULD NOT REPLICATE ERROR CODE 139. THE BOARD PASSED TESTING. RETAINING THE BOARD IN THE FAT DEPT. PER PROCEDURE NUMBER 0002-07-D008 REV. AU. RC1 ¿ THERE IS NO SURGE PROTECTION IN THE INTERFACE BETWEEN THE CHARGING CIRCUITRY AND THE BATTERIES INSTALLED IN THE POWER SLOTS OF THE UNIT. RC2 ¿ THE TANTALUM CAPACITORS USED ON THE FOLLOWING TWO (2) PCBAS ARE NOT WITHIN THE CAPACITOR MANUFACTURER¿S (VISHAY) DE-RATING GUIDELINES WHICH MAY RESULT IN CAPACITOR FAILURE CAUSING AN OVERCURRENT CONDITION ON THE VBULK POWER SUPPLY WHICH DAMAGES THE POWER MANAGEMENT BOARD. CAPA 566812 ROOT CAUSE #1: SERIAL DATA FROM THE POWER MANAGEMENT BOARD IS SENT WHILE THE EXECUTIVE BOARD IS STILL POWERING UP. MOST OF THE TIME THE EXECUTIVE BOARD CAN DEAL WITH THE EXCESS SERIAL DATA WITHOUT INCIDENT. HOWEVER, IN THE FAILURE CASE THE EXECUTIVE BOARD THROWS AN ERROR THAT IS NOT HANDLED CORRECTLY AND CAUSES THE UNIT TO GO INTO SYSTEM FAILURE. -CAPA 539589.

Description of Event or Problem · 0

IT WAS REPORTED THAT PRIOR TO USE, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) WAS ALARMING AND WILL NOT BOOT. THERE WAS NO PATIENT INVOLVEMENT.

Description of Event or Problem · 0

N/A.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2020472 CARDIOSAVE HYBRID, TYPE B PLUG SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL DSP DATASCOPE CORP. 0998-00-0800-53 10607567108391

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown