FDA Adverse Event Injury Summary report: N

HLS CANNULA + PIK

MDR report key: 24107231 · Received January 19, 2026

Report

Report Number
8010762-2026-0000016
Event Type
Injury
Date Received
January 19, 2026
Date of Event
June 25, 2024
Report Date
May 21, 2026
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
DWF
PMA / PMN Number
K102532
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE INVESTIGATION IS ONGOING. FURTHER INFORMATION HAS BEEN REQUESTED BUT HAS NOT YET BEEN RECEIVED. A FOLLOW UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. NOTE: NO UDI NUMBER HAS BEEN INCLUDED IN THE SECTION D4 UNIQUE DEVICE IDENTIFIER (UDI) SINCE THE LOT NUMBER OF THE AFFECTED SET WAS NOT PROVIDED. THEREFORE IT IS NOT POSSIBLE TO IDENTIFY THE SET LOT NUMBER OF THE DEVICE IN QUESTION AND THEREFORE ITS UDI NUMBER.

Description of Event or Problem · 0

MAQUET CARDIOPULMONARY GMBH HAS RECEIVED THE FOLLOWING INFORMATION FROM THE SPANISH AGENCY OF MEDICINES AND MEDICAL DEVICE ON 2026-01-13: THE VIGILANCE AREA OF MEDICAL DEVICES OF THE SPANISH AGENCY OF MEDICINES AND MEDICAL DEVICES HAS BEEN INFORMED THROUGH RENACER REGISTRY ABOUT AN INVOLVING THE PRODUCT ¿CARDIOHELP SYSTEM¿, MANUFACTURED BY MAQUET CARDIOPULMONARY GMBH, OCCURRED ON (B)(6) 2024 IN (B)(6) HOSPITAL. THE INFORMATION PROVIDED IS THE FOLLOWING: ¿THROMBUS ADHERED TO RIGHT ATRIAL CANNULA..¿ CONSEQUENCES FOR THE PATIENT: NEED FOR MEDICAL INTERVENTION TO PREVENT INJURIES OR PERMANENT DISABILITY. MEASURES: INCREASE IN COAGULATION RANGE. BASED ON THE INFORMATION AVAILABLE THAT A SERIOUS INJURY WAS REPORTED A REPORT IS REQUIRED. COMPLAINT ID: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
335774 HLS CANNULA + PIK CATHETER, CANNULA AND TUBING, VASCULAR, CARDIOPULMONARY BYPASS DWF MAQUET CARDIOPULMONARY GMBH UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1