FDA Adverse Event Malfunction Summary report: N

TUBING SET

MDR report key: 25067534 · Received May 4, 2026

Report

Report Number
8010762-2026-0000204
Event Type
Malfunction
Date Received
May 4, 2026
Date of Event
April 24, 2026
Report Date
May 26, 2026
Manufacturer
MAQUET CARDIOPULMONARY GMBH
Product Code
DTZ
PMA / PMN Number
K112360
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HK
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. NOTE: THIS EVENT OCCURRED ON THE HONG KONG MARKET. IT IS A SIGNIFICANTLY SIMILAR DEVICE TO "HLS SET¿ WHICH IS SOLD IN THE USA UNDER PREMARKET SUBMISSION NUMBER K112360. FOR SECTION D4 ALL AVAILABLE IDENTIFYING INFORMATION IS FOR THE OUT OF THE US DEVICE, SUBJECTED TO THIS REPORT. THEREFORE, NO GUDID INFORMATION EXISTS. FURTHERMORE, 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 YET. THEREFORE IT IS NOT YET POSSIBLE TO IDENTIFY THE SET LOT NUMBER OF THE DEVICE IN QUESTION AND THEREFORE ITS UDI NUMBER.

Description of Event or Problem · 0

THE EVENT OCCURRED IN HONG KONG. IT WAS REPORTED THAT THERE WAS A "WEIRD NOISE" DURING PATIENT TREATMENT. THE INVOLVED CARDIOHELP DEVICE AS WELL AS THE HLS-SET INVOLVED WERE REPLACED. THE HLS-SET WAS NOT KEPT BY THE CUSTOMER FOR INVESTIGATION. DURING INSPECTION OF THE CARDIOHELP DEVICE BY THE TECHNICIAN NO MALFUNCTION WAS FOUND. NO HARM TO ANY PERSON HAS BEEN REPORTED. THE INVOLVED CARDIOHELP DEVICE WILL BE INVESTIGATED UNDER COMPLAINT ID# (B)(4). AS THE HLS-SET WAS REPLACED DURING TREATMENT, A REPORT IS REQUIRED. COMPLAINT ID# (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
29005 TUBING SET OXYGENATOR, CARDIOPULMONARY BYPASS DTZ MAQUET CARDIOPULMONARY GMBH HLS SET 3000506411

Patients

Seq Age Sex Outcome Treatment
1