SORIN S3 BUBBLE DETECTOR SENSOR 23-07-40

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 2016-12-06 for SORIN S3 BUBBLE DETECTOR SENSOR 23-07-40 manufactured by Sorin Group Deutschland.

Event Text Entries

[61614277] Patient information was not provided. Sorin group (b)(4) manufactures the sorin s3 bubble detector sensor. The incident occurred in (b)(6). This medwatch report is being filed on behalf of sorin group (b)(4). A sorin group field service representative was dispatched to the facility to investigate. The service representative confirmed the reported issue and replaced the bubble sensor. Subsequent testing did not identify further issues and the unit was returned to service. A review of the dhr did not identify any deviations or non-conformities relevant to the reported issue. The investigation is ongoing. A follow-up report will be sent when the investigation is complete.
Patient Sequence No: 1, Text Type: N, H10


[61614278] Sorin group (b)(4) received a report that an error message was displayed on the heart-lunch machine regarding the sorin s3 bubble detector sensor during a procedure. There is no report of patient injury.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9611109-2016-00808
MDR Report Key6149886
Report SourceHEALTH PROFESSIONAL
Date Received2016-12-06
Date of Report2016-11-10
Date of Event2016-11-10
Date Mfgr Received2016-11-10
Device Manufacturer Date2016-02-04
Date Added to Maude2016-12-06
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 G1SORIN GROUP 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 S3 BUBBLE DETECTOR SENSOR
Generic NameMONITOR AND/OR CONTROL, LEVEL SENSING, CARDIOPULMONARY BYPASS
Product CodeKRL
Date Received2016-12-06
Model Number23-07-40
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSORIN GROUP DEUTSCHLAND
Manufacturer AddressLINDBERGHSTR. 25 MUNICH, 80939 GM 80939


Patients

Patient NumberTreatmentOutcomeDate
10 2016-12-06

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