FDA Adverse Event Malfunction Summary report: N

CS300

MDR report key: 3031023 · Received March 28, 2013

Report

Report Number
2249723-2013-00025
Event Type
Malfunction
Date Received
March 28, 2013
Date of Event
February 18, 2013
Report Date
February 18, 2013
Manufacturer
DATASCOPE CORP.
Product Code
DSP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
BIOMEDICAL ENGINEER

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REP REPLACED THE MOTOR CONTROLLER PCB (PART NUMBER (B)(4)). IN UNRELATED REPAIRS, THE FILTER TUBING AND THE EXPIRED SAFETY DISK WERE ALSO REPLACED. THE IABP WAS TESTED TO FACTOR 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, THE IABP GENERATED A "LOW VACUUM" ALARM AND SHUT DOWN. THE PT WAS SWITCHED TO ANOTHER IABP AND THERAPY WAS CONTINUED. NO PT INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
129665 CS300 INTRA-AORTIC BALLOON PUMP DSP DATASCOPE CORP. CS300 NA

Patients

Seq Age Sex Outcome Treatment
1 NI