FDA Adverse Event Malfunction Summary report: N

INSPIRE 6F DUAL HOLLOW FIBER OXY W/ INTEGRATED HARDSHELL VEN/CARD RES

MDR report key: 8000251 · Received October 24, 2018

Report

Report Number
9680841-2018-00028
Event Type
Malfunction
Date Received
October 24, 2018
Date of Event
September 6, 2018
Report Date
December 5, 2018
Manufacturer
SORIN GROUP ITALIA SRL
Product Code
DTZ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 0

PATIENT INFORMATION WAS NOT PROVIDED THE INSPIRE 6F DUAL HOLLOW FIBER OXYGENATOR IS A NON-STERILE DEVICE ASSEMBLED INTO A STERILE CONVENIENCE PACK (LOT 1804160162) THAT IS NOT DISTRIBUTED IN THE USA. THE EXPIRATION DATE REFERS TO THE STERILE FINISHED PRODUCT INTO WHICH THE OXYGENATOR WAS ASSEMBLED. AS THE STERILE CONVENIENCE PACK IS NOT DISTRIBUTED IN USA, THE UDI NUMBER IS NOT APPLICABLE. THE AGE OF THE DEVICE WAS CALCULATED AS THE TIME ELAPSED BETWEEN DEVICE STERILIZATION AND THE DATE OF EVENT. (B)(4). THE COMPLAINED INSPIRE 6F HOLLOW FIBER OXYGENATOR IS A NON-STERILE COMPONENT ASSEMBLED INTO A CONVENIENCE PACK THAT IS NOT DISTRIBUTED IN THE USA. THE STAND ALONE OXYGENATOR (CATALOG NUMBER 050715) IS REGISTERED IN THE USA (510(K) NUMBER: K130209). THE DEVICE MANUFACTURE DATE REFERS TO MANUFACTURE DATE OF THE STERILE, FINISHED CONVENIENCE PACK INTO WHICH THE OXYGENATOR WAS ASSEMBLED. SORIN GROUP (B)(4) MANUFACTURES THE INSPIRE 6F M HOLLOW FIBER OXYGENATOR. THE INCIDENT OCCURRED IN (B)(6). PER EXEMPTION NUMBER E2016005. THE INVOLVED DEVICE HAS BEEN REQUESTED FOR RETURN TO SORIN GROUP (B)(4) FOR INVESTIGATION. IF ANY ADDITIONAL INFORMATION PERTINENT TO THE REPORTED EVENT IS OBTAINED, IT WILL BE PROVIDED IN A SUPPLEMENTAL REPORT. NOT YET RETURNED FROM DECONTAMINATION.

Additional Manufacturer Narrative · 0

SORIN GROUP ITALIA MANUFACTURES THE INSPIRE 6F M HOLLOW FIBER OXYGENATOR. THE INCIDENT OCCURRED IN BAD BEVENSEN, GERMANY. PER EXEMPTION NUMBER E2016005, SORIN GROUP ITALIA S.R.L. IS SUBMITTING THE REPORT FOR BOTH SORIN GROUP ITALIA S.R.L (MANUFACTURER) AND LIVANOVA USA., INC. (IMPORTER). THE INVOLVED DEVICE WAS RETURNED TO SORIN GROUP ITALIA FOR INVESTIGATION. VISUAL INSPECTION OF THE DEVICE DID NOT IDENTIFY ANY VISIBLE DEFECT. TO EVALUATE THE PRESSURE DROP UNDER STANDARD CONDITIONS, SIMULATED USE TESTING WAS PERFORMED. NO DEVICE MALFUNCTION WAS IDENTIFIED DURING THIS TESTING. THE DEVICE WAS FOUND TO BE CONFORMING TO THE MANUFACTURER SPECIFICATIONS. A REVIEW OF THE DHR DID NOT IDENTIFY ANY DEVIATIONS OR NON-CONFORMITIES RELEVANT TO THE REPORTED ISSUE. AS THE ISSUE COULD NOT BE REPRODUCED, A ROOT CAUSE WAS NOT DETERMINED. HOWEVER, BASED ON EVIDENCE FROM PREVIOUSLY INVESTIGATED CASES FOR SIMILAR ISSUES, SORIN GROUP ITALIA BELIEVES THE LIKELY ROOT CAUSE OF THE INCREASED PRESSURE DROP TO BE PLATELET ADHESION AND FIBRIN LAYER DEPOSITION INSIDE THE OXYGENATOR. THE MOST PROBABLE ROOT CAUSE OF PLATELET ADHESION AND FIBRIN DEPOSITION IS MULTI-FACTORIAL AND INCLUDES THE CLINICAL PROCEDURE (E.G SURGICAL MATERIAL), THERAPIES (E.G. ANTICOAGULANT PRESCRIPTION, HEPARIN COMPOSITION AND PRIMING COMPOSITION) AND PATIENT SPECIFIC HEALTH CONDITIONS. THE EVENT DOES NOT APPEARS TO BE DEVICE-SPECIFIC.

Description of Event or Problem · 0

SORIN GROUP (B)(4) RECEIVED A REPORT OF HIGH TRANSMEMBRANE PRESSURE AT THE INLET OF THE INSPIRE 6F DUAL HOLLOW FIBER OXYGENATOR DURING A PROCEDURE. THERE WAS NO REPORT OF PATIENT INJURY. THROUGH FOLLOW-UP COMMUNICATION WITH THE CUSTOMER ON (B)(6) 2018, SORIN GROUP (B)(4) HAS BEEN INFORMED THAT THE PROCEDURE WAS PROLONGED FOR MORE THAT 30 MINUTES DUE TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
841234 INSPIRE 6F DUAL HOLLOW FIBER OXY W/ INTEGRATED HARDSHELL VEN/CARD RES OXYGENATOR, CARDIOPULMONARY BYPASS DTZ SORIN GROUP ITALIA SRL 03704 1803290311

Patients

Seq Age Sex Outcome Treatment
1