BEUDAMED
    FDA Adverse Event Other Summary report: N

    STOCKERT CENTRIFUGAL PUMP SYSTEM WITH TUBING CLAMP

    MDR report key: 3883991 · Received June 12, 2014

    Report

    Report Number
    1718850-2014-00178
    Event Type
    Other
    Date Received
    June 12, 2014
    Date of Event
    May 5, 2014
    Report Date
    May 16, 2014
    Manufacturer
    SORIN GROUP DEUTSCHLAND
    Product Code
    DWA
    PMA / PMN Number
    K032213
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    PATIENT INFO WAS NOT PROVIDED. SORIN GROUP (B)(4) MANUFACTURES THE STOCKERT CENTRIFUGAL PUMP SYSTEM WITH TUBING CLAMP. THE INCIDENT OCCURRED IN (B)(6). THIS MEDWATCH REPORT IS FILED ON BEHALF OF SORIN GROUP (B)(4). SORIN GROUP REC'D A REPORT THAT THE STOCKERT CENTRIFUGAL PUMP DISPLAYED AN ERROR AND THE PUMP STOPPED DURING A PROCEDURE. THERE WAS NO REPORT OF PATIENT INJURY. THE INVESTIGATION IS ONGOING. A F/U REPORT WILL BE SENT WHEN THE INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 1

    SORIN GROUP REC'D A REPORT THAT THE STOCKERT CENTRIFUGAL PUMP DISPLAYED AN ERROR AND THE PUMP STOPPED DURING A PROCEDURE. THERE WAS NO REPORT OF PATIENT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    348020 STOCKERT CENTRIFUGAL PUMP SYSTEM WITH TUBING CLAMP CONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS DWA SORIN GROUP DEUTSCHLAND 60-00-00 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NP