FDA Adverse Event Malfunction Summary report: N

CARDIOSAVE

MDR report key: 4001888 · Received June 10, 2014

Report

Report Number
2249723-2014-00537
Event Type
Malfunction
Date Received
June 10, 2014
Date of Event
September 12, 2012
Report Date
September 12, 2012
Manufacturer
DATASCOPE CORP.
Product Code
DSP
PMA / PMN Number
K112372
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE COMPANY REP OBSERVED MANY LOG ERROR CODE 37S 'FILL FAIL-SHUTTLE PURGE TIME OUT' AND 'DEAD VOLUME CALC. TIMEOUT'. THE COMPANY REP CONFIRMED THAT THE PIM CONNECTOR WAS OK AND PERFORMED A LEAK TEST AND THERE WAS NO ERROR AND THE CARDIOSAVE WORKED WELL. SUBSEQUENTLY THE CARDIOSAVE PERIODICALLY DISPLAYED AN 'AUTOFILL' ERROR MESSAGE DURING THE FIRST AUTOFILLS. AS A PRECAUTIONARY MEASURE, THE COMPANY REP REPLACED THE PNEUMATIC INTERFACE MOD ASSEMBLY (PART NUMBER 0997-00-0582. (B)(4).

Description of Event or Problem · 1

THE COMPANY REP, DURING A ROUTINE CHECK, OBSERVED THAT THE IABP GENERATED A "AUTO FILL ERROR". NO PT WAS INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
337151 CARDIOSAVE INTRA-AORTIC BALLOON PUMP DSP DATASCOPE CORP. CARDIOSAVE

Patients

Seq Age Sex Outcome Treatment
1