FDA Adverse Event Malfunction Summary report: N

TERUMO CDI 500 BLOOD PARAMETER MONITOR

MDR report key: 2852426 · Received November 13, 2012

Report

Report Number
1828100-2012-01438
Event Type
Malfunction
Date Received
November 13, 2012
Date of Event
October 19, 2012
Report Date
October 19, 2012
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
DRY
PMA / PMN Number
K972962
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINT WAS CONFIRMED BY THE SVC REPAIR TECH. THE POWER SUPPLY WAS REPLACED. THE UNIT WAS TESTED TO MFR'S SPECIFICATIONS AND RETURNED TO CLINICAL USE. IF ADDITIONAL INFO BECOMES AVAILABLE ON THIS COMPLAINT THAT WOULD ALTER THE FACTS AND/OR CONCLUSION, A SUPPLEMENTAL REPORT WILL BE FILED ACCORDINGLY.

Description of Event or Problem · 1

THE SERVICE REPAIR TECH REPORTED THAT DURING SAFETY TESTING OF THE DEVICE AT THE SVC CENTER, THE UNIT FAILED THE HIGH POTENTIAL TEST ON BOTH ARTERIAL AND VENOUS BLOOD PARAMETER MONITORS. THERE WAS NO PT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO CDI 500 BLOOD PARAMETER MONITOR DRY TERUMO CARDIOVASCULAR SYSTEMS CORP. 500AVHCT

Patients

Seq Age Sex Outcome Treatment
1