FDA Adverse Event Malfunction Summary report: N

DIDECO ELECTRA AUTOTRANSFUSION KIT

MDR report key: 785279 · Received September 6, 2006

Report

Report Number
1718850-2006-00046
Event Type
Malfunction
Date Received
September 6, 2006
Date of Event
May 25, 2006
Report Date
June 30, 2006
Manufacturer
SORINE GROUP ITALIA S.R.L.
Product Code
CAC
PMA / PMN Number
K020647
Removal / Correction Number
PENDING
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT INVOLVED WAS RETURNED AND VISUALLY AND DIMENSIONALLY INSPECTED. THE INSPECTION FOUND A DEFECTIVE COUPLING ANGLE BETWEEN THE CENTRIFUGE MOUNTING RING AND THE BOTTOM OF THE BOWL. ADDITIONAL EVALUATION WAS PERFORMED ON THE WASH SETS IN THE BRACKET THAT INCLUDED THIS LOT. THAT EVALUATION INCLUDED PERFORMANCE TESTING AND REVEALED THAT IF THE BOWL CANNOT BE INSERTED INTO THE CENTRIFUGE IN ACCORDANCE WITH THE IFU, THERE IS A RISK THAT THE BOWL'S ROTATING SEAL AREA COULD DETERIORATE DURING OPERATION, RELEASING PARTICULATES INTO THE PROCESSED BLOOD. THE LOADING OF WASH SETS FROM THIS BRACKET OF PRODUCT CAN BE MORE DIFFICULT DUE TO A MANUFACTURING PROCESS ERROR THAT RESULTED IN A SLIGHT DEFORMATION IN THE MOUNTING RING ON THE BOWL BOTTOM. THE PROCESS ERROR HAS SUBSEQUENTLY BEEN CORRECTED BY SORIN GROUP. SORIN GROUP COMPLETED A RISK ASSESSMENT THAT LEAD TO A FIELD NOTIFICATION THAT INCLUDED THE PRODUCT SOLD IN THE US. THE FIELD NOTIFICATION IN THE US WAS CONDUCTED BY COBE CARDIOVASCULAR, INC., THE DISTRIBUTOR OF THE US DEVICES. THE LOCAL FDA OFFICE WAS NOTIFIED OF THE FIELD ACTION AND THE REPORTING NUMBER WILL BE PROVIDED WHEN IT IS AVAILABLE.

Description of Event or Problem · 1

THE BOWL MADE AN ABNORMAL SOUND. THE MACHINE WOULD NOT RECOGNIZE THE BOWL SIZE, DURING THE SET UP, SO THE OPERATOR REPLACED THE BOWL BEFORE PROCEEDING WITH THE CASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 DIDECO ELECTRA AUTOTRANSFUSION KIT APPARATUS, AUTOTRANSFUSION CAC SORINE GROUP ITALIA S.R.L. NA 0602030111

Patients

Seq Age Sex Outcome Treatment
1 NA