FDA Adverse Event Injury Summary report: N

ROTAFLOW ENGLISH/US US-PLUG ICU

MDR report key: 4791736 · Received May 21, 2015

Report

Report Number
8010762-2015-00446
Event Type
Injury
Date Received
May 21, 2015
Manufacturer
MAQUET CARDIOPULMONARY AG
Product Code
DTQ
PMA / PMN Number
K991864
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). MAQUET CARDIOPULMONARY PROVIDES PRODUCT FAILURE INVESTIGATION, ANALYSIS AND RESOLUTION FOR THE DEVICE DESCRIBED IN THIS REPORT. THE DEVICE WAS INVESTIGATED BY A MAQUET SERVICE TECHNICIAN. UPON ARRIVAL THE BATTERY WAS TESTED. THE UNIT POWERED ON WITH THE BATTERY READING 23.4 VOLTS. TESTED AT 2500 RMP/4LPM ON BATTERY. UNIT RAN FOR 108 MINUTES BEFORE LOW BATTERY ALARM. PLUGGED IN AND VERIFIED UNIT WAS CHARGING. UNABLE TO DUPLICATE THE SHORT RUN TIME. PERFORMED FUNCTIONAL TESTS. VERIFIED THE UNIT WAS CALIBRATED TO FACTORY SPECIFICATIONS. SAFETY INSPECTED. A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. REFERENCE EXEMPTION # (B)(4).

Description of Event or Problem · 1

(B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
333347 ROTAFLOW ENGLISH/US US-PLUG ICU DTQ MAQUET CARDIOPULMONARY AG

Patients

Seq Age Sex Outcome Treatment
1