SORIN S5 BUBBLE DETECTOR 23-07-50

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2016-10-07 for SORIN S5 BUBBLE DETECTOR 23-07-50 manufactured by Sorin Group Deutschland.

Event Text Entries

[56923328] Sorin group (b)(4) manufactures the sorin centrifugal pump system. The incident occurred in (b)(4). This medwatch report is being filed on behalf of sorin group (b)(4). Sorin group (b)(4) received a report that the sorin s5 bubble detector cushions were found to be deflated during a procedure. There was no report of patient injury. A sorin group field service representative was dispatched the facility to investigate. The service representative was unable to identify the issue on site. The bubble sensor was returned to sorin group (b)(4) for further investigation. The investigation is ongoing. A follow-up report will be sent when the investigation is complete. Evaluation in progress.
Patient Sequence No: 1, Text Type: N, H10


[56923329] Sorin group (b)(4) received a report that the sorin s5 bubble detector cushions were found to be deflated during a procedure. There was no report of patient injury.
Patient Sequence No: 1, Text Type: D, B5


[73368035] Livanova (b)(4) manufactures the centrifugal pump system. The incident occurred in (b)(6). This medwatch report is being filed on behalf of livanova (b)(4). The bubble sensor was returned to livanova (b)(4) for evaluation. Detailed inspection identified a tear in the right side pillow and the gel had leaked out. The specific cause of the tear cannot be determined as it occurred during use by the customer. A review of the dhr did not identify any deviations or non-conformities relevant to the reported issue. A trend of failing bubble sensors due to leaks in cushions has not been identified so far. However, capa (b)(4) was initiated to evaluate the lifetime of the bubble sensor.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9611109-2016-00632
MDR Report Key6012744
Report SourceHEALTH PROFESSIONAL
Date Received2016-10-07
Date of Report2017-03-24
Date of Event2016-09-07
Date Mfgr Received2017-03-01
Device Manufacturer Date2016-02-03
Date Added to Maude2016-10-07
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactJOAN CEASAR
Manufacturer Street14401 W. 65TH WAY
Manufacturer CityARVADA CO 80004
Manufacturer CountryUS
Manufacturer Postal80004
Manufacturer Phone2812287260
Manufacturer G1LIVANOVA DEUTSCHLAND
Manufacturer StreetLINDBERGHSTR. 25
Manufacturer CityMUNICH, 80939
Manufacturer CountryGM
Manufacturer Postal Code80939
Single Use3
Remedial ActionOT
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSORIN S5 BUBBLE DETECTOR
Generic NameDETECTOR, BUBBLE, CARDIOPULMONARY BYPASS
Product CodeKRL
Date Received2016-10-07
Returned To Mfg2016-09-19
Model Number23-07-50
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSORIN GROUP DEUTSCHLAND
Manufacturer AddressLINDBERGHSTR. 25 MUNICH, 80939 GM 80939


Patients

Patient NumberTreatmentOutcomeDate
10 2016-10-07

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