FDA Adverse Event Injury Summary report: N

MAQUET CARDIOPULMONARY AG

MDR report key: 3953205 · Received June 20, 2014

Report

Report Number
3008355164-2014-00116
Event Type
Injury
Date Received
June 20, 2014
Date of Event
May 21, 2014
Report Date
May 21, 2014
Manufacturer
MAQUET CARDIOPULMONARY AG
Product Code
KFM
Adverse Event
Yes
Product Problem
Yes
Report Source
Distributor report
Reporter Location
MD, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THE ROTAFLOW PUMP STOPPED WHILE ON A PT. THE KNOB WOULD NOT INITIATE FLOW. THE CURSOR PLATE HAD TO BE TURNED COUNTER CLOCKWISE TO ENGAGE THE KNOB TO INITIATE FLOW. THE CURSOR WAS LOOSE AND SPUN FREELY. THE UNIT HAD TO BE HAND CRANKED TO BE PRIMED. ONCE THE UNIT WAS STARTED IT FLOWED FROM MULTIPLE HOURS. UPON TRANSFER TO ANOTHER FACILITY THE DRIVE CABLE WAS DISCONNECTED AND THE FLOW WENT TO DASHES AND THE CURSOR PLATE HAD TO BE ROTATED COUNTERCLOCKWISE TO INITIATE FLOW. HAND-CRANKING WAS INITIATED FOR 30 MINUTES. NO REPORTED PT EFFECT. (B)(4). REF MFR REPORT#: 8010762-2014-00243.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
363529 MAQUET CARDIOPULMONARY AG ROTAFLOW CONSOLE KFM MAQUET CARDIOPULMONARY AG 701051712

Patients

Seq Age Sex Outcome Treatment
1 Other| R