FDA Adverse Event Malfunction Summary report: N

CARDIOHELP SYSTEM

MDR report key: 4278592 · Received November 26, 2014

Report

Report Number
8010762-2014-00772
Event Type
Malfunction
Date Received
November 26, 2014
Date of Event
October 6, 2011
Report Date
October 6, 2011
Manufacturer
MAQUET CARDIOPULMONARY AG
Product Code
DTQ
PMA / PMN Number
K133598
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). ON (B)(6) 2012, A CREDIT NOTE WAS ISSUED FOR THE BATTERIES. HOWEVER, NO REPAIR INFORMATION WAS PROVIDED. REFERENCE: COMPLAINT (B)(4).

Description of Event or Problem · 1

ON (B)(6) 2011, NEW REPLACEMENT BATTERIES (LOT 90009008, DATE CODE= 2010-12) WERE INSTALLED INSIDE FOUR(4) CARDIOHELP (SERIAL NUMBERS (B)(4), (B)(4), (B)(4),AND (B)(4)) MACHINES. AFTER THE BATTERIES WERE REPLACED AND THE UNITS WERE POWERED ON, THE UNITS DISPLAYED A "BATTERY DEFECTIVE" MESSAGE. ADDITIONALLY, THE UNITS WOULD NOT ACCEPT A CHARGE.NOTE: THE ORIGINAL BATTERIES IN THE UNITS WERE FROM THE SAME LOT (LOT 90009008, DATE CODE= 2010-12). THIS INCIDENT DID NOT OCCUR DURING USE. THIS MEDWATCH IS BEING SUBMITTED FOR SERIAL NUMBER (B)(4). MFR REPORT# 8010762-2014-00518 WILL BE USED FOR SERIAL NUMBER (B)(4). MFR REPORT# 8010762-2014-00771 WILL BE USED FOR SERIAL NUMBER (B)(4). MFR REPORT# 8010762-2014-00773 WILL BE USED FOR SERIAL NUMBER (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
768929 CARDIOHELP SYSTEM HEART-LUNG,CARDIOPULMONARY BYPASS DTQ MAQUET CARDIOPULMONARY AG 70104.8012

Patients

Seq Age Sex Outcome Treatment
1