FDA Adverse Event Injury Summary report: N

KAAT II+:E/FE W/REC & HEL 115V

MDR report key: 747058 · Received August 9, 2006

Report

Report Number
1219856-2006-00269
Event Type
Injury
Date Received
August 9, 2006
Date of Event
July 17, 2006
Report Date
August 9, 2006
Manufacturer
ARROW INTL., INC.
Product Code
DSP
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
INVALID DATA

Narratives

Additional Manufacturer Narrative · 1

DEVICE IS NOT AVAILABLE FOR EVAL. NO FURTHER EVAL POSSIBLE. ROOT CAUSE UNK.

Description of Event or Problem · 1

IT WAS REPORTED TO ARROW CLINICAL SUPPORT (ACS) THAT CLINICIAN WAS HAVING SYSTEM ERROR 3 ALARMS. ACS ADVISED THAT BELLOWS MAY BE CAUSE OF ALARMS. CLINICAIN AGREED. PUMP WAS EXCHANGED AND AN ACAT 1 PLUS. THERE WERE NO REPORTED PT COMPLICATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KAAT II+:E/FE W/REC & HEL 115V INTRA-AORTIC BALLOON PUMP PRODUCTS DSP ARROW INTL., INC. NA *

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Required Intervention