FDA Adverse Event Malfunction Summary report: N

8010762-2019-00043

MDR report key: 8366991 · Received February 25, 2019

Report

Report Number
8010762-2019-00043
Event Type
Malfunction
Date Received
February 25, 2019
Date of Event
February 11, 2019
Report Date
February 25, 2019
PMA / PMN Number
K102726
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

(B)(4). A FOLLOW-UP MEDWATCH WILL BE SUBMITTED WHEN ADDITIONAL INFORMATION BECOMES AVAILABLE. (B)(4). REFERENCE EXEMPTION # E2018002. THE E-DRIVE WAS SENT TO REPAIR DEPOT IN (B)(4). WORK PERFORMED ON 2019-02-19. RESULTS OF SERVICE ORDER REPORT (B)(4): "E-DRIVE REPAIR. BOTTOM GEAR WAS PROPERLY INSTALLED TO ALLOW HAND CRANK TO TURN IN A CLOCKWISE DIRECTION TO ENGAGE PROPER FLOW. PERFORMED FULL FUNCTIONAL TEST AS PER SERVICE MANUAL. ALL TESTS PASSED. NOTE: REFERENCE TRACKWISE COMPLAINT # (B)(4)" E-DRIVE HAND CRANK TURNING COUNTER-CLOCKWISE" REPAIRED SEE ABOVE DESCRIPTION." THE ROOT CAUSE IS A HUMAN ERROR DURING SERVICE/ MAINTENANCE. THUS THE FAILURE COULD BE CONFIRMED. THE DATA IS ALSO BEING HANDLED THROUGH A DESIGNATED MAQUET CARDIOPULMONARY TRENDING AND APPLICABLE INVESTIGATION PROCESS. DUE TO THIS NO FURTHER INVESTIGATION INITIATIONS WILL BE COMPLETED AT THIS TIME. AS A CORRECTIVE ACTION AN NON-CONFORMANCE-PROCESS (NC) WAS INITIATED: (B)(4).

Description of Event or Problem · 0

(B)(4). IT WAS DISCOVERED THAT THE E-DRIVE IS TURNING ANTICLOCKWISE. THE FACTORY HAS CHECKED ON THIS AND TURNING THE HAND CRANK COUNTERCLOCKWISE ACTUALLY WILL DAMAGE THE BLOOD CELLS. THE CORRECT DIRECTION OF THE HAND CRANK IS CLOCKWISE WHERE YOU WOULD FEEL SOME RESISTANCE. THAT IS WHEN THAT 1 GEAR IS INSTALLED CORRECTLY AND THEN TURNING THE HAND CRANK COUNTER-CLOCKWISE THERE ISN¿T RESISTANCE AND IT IS FREE SPINNING.

Patients

Seq Age Sex Outcome Treatment
1 Other