FDA Adverse Event Malfunction Summary report: N

CS100

MDR report key: 2961199 · Received January 30, 2013

Report

Report Number
2249723-2013-00004
Event Type
Malfunction
Date Received
January 30, 2013
Date of Event
November 29, 2012
Report Date
November 29, 2012
Manufacturer
DATASCOPE CORP
Product Code
DSP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REPRESENTATIVE REPLACED THE BATTERIES (PART NUMBER 0146-00-0039). IN AN UNRELATED REPAIR, THE ECG PT CABLE WAS REPLACED, ALONG WITH THE ECG SNAP LEAD WIRES. THE IABP WAS TESTED TO FACTORY SPECIFICATION. IT FUNCTIONED NORMALLY AND WAS RETURNED TO THE CUSTOMER. (B)(4).

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT WHILE THE IABP WAS IN USE ON A PT DURING TRANSPORT, THE IABP LOST BATTERY POWER AND SHUTDOWN AFTER APPROXIMATELY 50 MINUTES. THE IABP WAS PLUGGED INTO AN INVERTER ON THE HELICOPTER AND THERAPY WAS CONTINUED. NO PT INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
41637 CS100 INTER-AORTIC BALLOON PUMP DSP DATASCOPE CORP CS100 NA

Patients

Seq Age Sex Outcome Treatment
1 NI