FDA Adverse Event Malfunction Summary report: N

SYNCARDIA COMPANION 2 DRIVER

MDR report key: 3820642 · Received May 7, 2014

Report

Report Number
3003761017-2014-00067
Event Type
Malfunction
Date Received
May 7, 2014
Date of Event
April 28, 2014
Report Date
May 6, 2014
Manufacturer
SYNCARDIA SYSTEMS, INC.
Product Code
LOZ
PMA / PMN Number
P030011
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE CUSTOMER REPORTED THAT THE "RIGHT VACUUM INCORRECT" ALARM WOULD SHOW PERIODICALLY ON THE SCREEN OF THE COMPANION 2 DRIVER. THE PATIENT WAS SWITCHED TO A BACKUP DRIVER WITHOUT ADVERSE IMPACT. THIS ALLEGED FAILURE MODE POSES A LOW RISK TO THE PATIENT BECAUSE IT DOES NOT PREVENT THE COMPANION DRIVER FROM PERFORMING ITS LIFE-SUSTAINING FUNCTIONS. AN INVESTIGATION WILL BE CONDUCTED BY SYNCARDIA. THE RESULTS OF THE INVESTIGATION WILL BE PROVIDED IN A SUPPLEMENTAL MDR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
276745 SYNCARDIA COMPANION 2 DRIVER CIRCULATORY ASSIST DRIVER LOZ SYNCARDIA SYSTEMS, INC. NA NA

Patients

Seq Age Sex Outcome Treatment
1 19 YR NA.