TERUMO CDI 101 MONITOR 7101

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2012-07-20 for TERUMO CDI 101 MONITOR 7101 manufactured by Terumo Cardiovascular Systems Corp.

Event Text Entries

[2830576] It was reported that during preparation of the device for a cardiopulmonary bypass procedure, the hematocrit/o2 saturation monitoring clip was broken. The device was taped and was not changed out for the procedure. The surgical procedure was completed successfully, and there were no delays, no blood loss or no adverse consequences to the pt.
Patient Sequence No: 1, Text Type: D, B5


[10054089] Investigation in process, but not yet complete.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number1828100-2012-01035
MDR Report Key2670228
Report Source05,06
Date Received2012-07-20
Date of Report2012-06-27
Date of Event2012-06-26
Date Mfgr Received2012-06-27
Device Manufacturer Date2008-08-01
Date Added to Maude2012-08-06
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactKIPP DURBIN
Manufacturer Street6200 JACKSON ROAD
Manufacturer CityANN ARBOR MI 48103
Manufacturer CountryUS
Manufacturer Postal48103
Manufacturer Phone7346634145
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTERUMO CDI 101 MONITOR
Product CodeDTY
Date Received2012-07-20
Model Number7101
Catalog Number7101
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerTERUMO CARDIOVASCULAR SYSTEMS CORP
Manufacturer AddressANN ARBOR MI 48103 US 48103


Patients

Patient NumberTreatmentOutcomeDate
10 2012-07-20

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