FDA Adverse Event Malfunction Summary report: N

TERUMO TCM II COOLING AND HEATING SYSTEM

MDR report key: 3072590 · Received April 18, 2013

Report

Report Number
1828100-2013-00387
Event Type
Malfunction
Date Received
April 18, 2013
Date of Event
March 28, 2013
Report Date
March 28, 2013
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
DWC
PMA / PMN Number
K883603
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS UNIT WAS USED FOR TRAINING PURPOSES ONLY. THE UNIT WAS DISASSEMBLED AND REASSEMBLED DURING TRAINING CLASSES. THE UNIT IS CLEARLY MARKED "NOT FOR CLINICAL USE." THIS EVENT IS RELATED TO MDR # 1828100-2013-00325. THE SERVICE REPAIR TECHNICIAN (SRT) FOUND THE FUSE "F1" WAS BLOWN ON THE MAIN PRINTED CIRCUIT BOARD (PCB). THE SRT REPLACED THE CARDIOPLEGIA (CPG) RELAY AND THE F1 FUSE. WITH THE COMPONENTS REPLACED, THE COOLER HEATER UNIT OPERATED TO MANUFACTURER SPECIFICATIONS AND WAS RETURNED TO CLINICAL USE. IF ADDITIONAL INFORMATION 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 TECHNICIAN (SRT) REPORTED THAT DURING ROUTINE TESTING OF THE DEVICE AT THE SERVICE CENTER, THE COLLER HEATER UNIT WOULD NOT POWER UP. PER THE SRT, INITIALLY THE CARDIOPLEGIA (CPG) WATER SUPPLY FUNCTIONED TO SPECIFICATIONS. THEN HE NOTICED THE CARDIOPLEGIA CIRCULATION PUMP WAS STILL RUNNING AT A LOW SPEED EVEN THOUGH THE CPG MOTOR LIGHT EMITTING DIODE (LED) ON THE CONTROL PANEL HAD EXTINGUISHED. THE SRT POWERED THE COOLER HEATER OFF AND BACK ON AND IT STARTED THROUGH THE SELF-TEST SEQUENCE AND THEN WENT OFF AND WILL NOT POWER BACK ON. THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
167321 TERUMO TCM II COOLING AND HEATING SYSTEM DWC TERUMO CARDIOVASCULAR SYSTEMS CORP. 15747

Patients

Seq Age Sex Outcome Treatment
1