FDA Adverse Event Malfunction Summary report: N

ACROBAT-I STABILIZER

MDR report key: 7367877 · Received March 23, 2018

Report

Report Number
2242352-2018-00269
Event Type
Malfunction
Date Received
March 23, 2018
Date of Event
February 9, 2018
Report Date
March 23, 2018
Manufacturer
MAQUET CV
Product Code
MWS
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). A LOT HISTORY RECORD REVIEW WAS COMPLETED FOR THE REPORTED PRODUCT LOT NUMBER. THERE WAS NO NONCONFORMANCE RECORDED IN THE LOT HISTORY. SINCE THE DEVICE IS NOT AVAILABLE TO BE RETURNED TO US, A TECHNICAL EVALUATION CANNOT BE PERFORMED. PER OUR STANDARD SOP'S, ALL EVENTS ARE TRACKED AND TRENDED TO DETERMINE WHETHER OR NOT ANY TRENDS DEVELOP.

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING A CORONARY ARTERY BYPASS PROCEDURE, ACROBAT-I STABILIZER CUSTOMER GRADUALLY INCREASED THE VACUUM PRESSURE TO 30KPA, AND THEN TO 40KPA, BUT IT WAS UNABLE TO SECURE THE DEVICE. OPENED ANOTHER OM-10000, REPLACED THE TUBE, AND INCREASED THE PRESSURE. THEN IT WAS ABLE TO SECURE THE DEVICE. THE GGJ SALES PERSON CHECKED THE DEVICE CONNECTION AND NO PROBLEMS WERE FOUND. THE TUBE SEEMS TO HAVE A PROBLEM. THE HOSPITAL DID NOT REPORT ANY PATIENT EFFECTS.

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING A CORONARY ARTERY BYPASS PROCEDURE, ACROBAT-I STABILIZER CUSTOMER GRADUALLY INCREASED THE VACUUM PRESSURE TO 30KPA, AND THEN TO 40KPA, BUT IT WAS UNABLE TO SECURE THE DEVICE. OPENED ANOTHER OM-10000, REPLACED THE TUBE, AND INCREASED THE PRESSURE. THEN IT WAS ABLE TO SECURE THE DEVICE. THE GGJ SALES PERSON CHECKED THE DEVICE CONNECTION AND NO PROBLEMS WERE FOUND. THE TUBE SEEMS TO HAVE A PROBLEM. THE HOSPITAL DID NOT REPORT ANY PATIENT EFFECTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
210881 ACROBAT-I STABILIZER STABILIZER,HEART MWS MAQUET CV 25135319

Patients

Seq Age Sex Outcome Treatment
1