FDA Adverse Event Malfunction Summary report: N

HEART LUNG MACHINE

MDR report key: 24872672 · Received April 14, 2026

Report

Report Number
8010762-2026-0000179
Event Type
Malfunction
Date Received
April 14, 2026
Date of Event
April 13, 2026
Report Date
May 13, 2026
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
DTQ
UDI-DI
04037691773032
PMA / PMN Number
K943803
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
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. THIS EVENT OCCURRED ON THE INDIAN MARKET ON A SIGNIFICANTLY SIMILAR DEVICE TO "VARIO TWIN, HL 20 4-PUMPS", WHICH IS SOLD IN THE US UNDER PREMARKET SUBMISSION NUMBER K943803 FOR THE OUT OF THE US DEVICE, SUBJECTED TO THIS REPORT. FOR D4 UNIQUE IDENTIFIER (UDI)#, PRIMARY DI NUMBER HAS BEEN USED FOR VARIO TWIN, HL 20 4-PUMPS WITH CATALOG NUMBER 701043262, WHICH IS SOLD IN THE US. PROVIDED D4 SERIAL NUMBER AND H4 DEVICE MANUFACTURER DATE CORRESPOND TO DEVICE INVOLVED IN THE EVENT, NOT AVAILABLE IN US.

Description of Event or Problem · 0

IT WAS REPORTED THAT A HL 20 PUMP WITH SERIAL NUMBER (B)(6) DISPLAYED THE ERROR MESSAGE "HEAD". THE EVENT OCCURRED DURING A ROUTINE CHECK. NO HARM TO ANY PERSON HAS BEEN REPORTED. ACCORDING TO THE HL20 SERVICE MANUAL THE ERROR "HEAD" INDICATES THAT THE MOTOR TACHO SHOWS A VALUE BUT THE HEAD TACHO SHOWS 0 (ZERO). COMPLAINT ID: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
159748 HEART LUNG MACHINE CONSOLE, HEART-LUNG MACHINE, CARDIOPULMONARY BYPASS DTQ MAQUET CARDIOPULMONARY GMBH HL 20 04037691773032

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown