BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TERUMO ADVANCED PERFUSION SYSTEM 1

    MDR report key: 671847 · Received September 2, 2005

    Report

    Report Number
    1828100-2005-00077
    Event Type
    Malfunction
    Date Received
    September 2, 2005
    Date of Event
    August 4, 2005
    Report Date
    September 1, 2005
    Manufacturer
    TERUMO CARDIOVASCULAR SYSTEMS CORP
    Product Code
    DTQ
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SN
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    ONE POWER SUPPLY NOT OPERATING PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TERUMO ADVANCED PERFUSION SYSTEM 1 HEART-LUNG CONSOLE DTQ TERUMO CARDIOVASCULAR SYSTEMS CORP 801736 *

    Patients

    Seq Age Sex Outcome Treatment
    1 *