FDA Adverse Event Death Summary report: N

ARDIOHELP SYSTEM

MDR report key: 4580111 · Received March 4, 2015

Report

Report Number
3008355164-2015-00020
Event Type
Death
Date Received
March 4, 2015
Date of Event
February 7, 2015
Report Date
February 7, 2015
Manufacturer
MAQUET CARDIOPULMONARY AG
Product Code
DTQ
Adverse Event
Yes
Product Problem
Yes
Report Source
Distributor report
Reporter Location
WI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CARDIOHELP PUMP STOPPED FLOWING WHILE THE PT WAS BEING TURNED/MOVED. THE BLOOD FLOW COULD NOT BE RESTORED. THE PT EXPIRED. IT WAS REPORTED THAT THE UNIT WENT FROM 4 LITERS FLOW PER MINUTE TO ZERO LITERS FLOW PER MINUTE. ADD'L INFO: PT HAD AN OPEN CHEST. THIS EVENT IS RELATED TO MEDWATCH REPORT # 8010762-2015-00015 AND 3008355164-2015-0028 (HLS DISPOSABLE). (B)(4). MFR REF #: 8010762-2015-00068.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
149466 ARDIOHELP SYSTEM CARDIOPULMONARY SUPPORT SYSTEM DTQ MAQUET CARDIOPULMONARY AG 70104.8012

Patients

Seq Age Sex Outcome Treatment
1 68 YR Death