FDA Adverse Event Malfunction Summary report: N

TERUMO ADVANCED PERFUSION SYSTEM 1

MDR report key: 2833459 · Received October 26, 2012

Report

Report Number
1828100-2012-01362
Event Type
Malfunction
Date Received
October 26, 2012
Date of Event
October 1, 2012
Report Date
October 1, 2012
Manufacturer
TERUMO CARDIOVASCULAR SYSTEM CORP
Product Code
DTQ
PMA / PMN Number
K022947
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION IS IN PROCESS, BUT NOT YET COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING USE OF THE DEVICE FOR A CARDIOPULMONARY BYPASS PROCEDURE, THE SYSTEM'S BASE DISPLAYED AN ERROR MESSAGE "BATTERY MAY NOT HAVE FULL BACK-UP POWER". THE ERROR MESSAGE WENT AWAY AND THE DEVICE WAS NOT CHANGED OUT. THE SURGICAL PROCEDURE WAS COMPLETED SUCCESSFULLY, AND THERE WERE NO DELAYS, NO BLOOD LOSS OR NO ADVERSE CONSEQUENCES TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO ADVANCED PERFUSION SYSTEM 1 DTQ TERUMO CARDIOVASCULAR SYSTEM CORP 801763

Patients

Seq Age Sex Outcome Treatment
1