BEUDAMED
    FDA Adverse Event Other Summary report: N

    SYNTHESIS P.H.I.S.I.O. ADULT MEMBRANE OXYGENATOR WITH INTEGRATED ARTERIAL FILTER

    MDR report key: 4340617 · Received December 5, 2014

    Report

    Report Number
    1718850-2014-00454
    Event Type
    Other
    Date Received
    December 5, 2014
    Date of Event
    November 10, 2014
    Report Date
    November 10, 2014
    Manufacturer
    SORIN GROUP ITALIA
    Product Code
    DTZ
    PMA / PMN Number
    K073380
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    SORIN GROUP (B)(4) MANUFACTURERS THE SYNTHESIS OXYGENATOR SYSTEM. THE INCIDENT OCCURRED IN (B)(6). THIS MEDWATCH IS BEING FILED ON BEHALF OF SORIN GROUP (B)(4). SORIN GROUP RECEIVED A REPORT THAT, NEAR THE END OF THE PROCEDURE, THE USER NOTICED THE WATER IN THE WATER LINES CONNECTED TO THE SYNTHESIS OXYGENATOR WAS PINK. THERE WAS NO REPORT OF PATIENT INJURY. THE INVESTIGATION IS ONGOING. A FOLLOW-UP REPORT WILL BE SENT WHEN THE INVESTIGATION IS COMPLETE.

    Description of Event or Problem · 1

    SORIN GROUP RECEIVED A REPORT THAT, NEAR THE END OF THE PROCEDURE, THE USER NOTICED THE WATER IN THE WATER LINES CONNECTED TO THE SYNTHESIS OXYGENATOR WAS PINK. THERE WAS NO REPORT OF PATIENT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    786193 SYNTHESIS P.H.I.S.I.O. ADULT MEMBRANE OXYGENATOR WITH INTEGRATED ARTERIAL FILTER OXYGENATOR, CARDIOPULMONARY BYPASS DTZ SORIN GROUP ITALIA NA 1405210042

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK