SARNS 8000 PERFUSION SYSTEM 16413

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-07-11 for SARNS 8000 PERFUSION SYSTEM 16413 manufactured by Terumo Cardiovascular Systems Corporation.

Event Text Entries

[80054242] (b)(4). Evaluation is in progress, but not yet concluded. Per field service representative (fsr), the arterial monitor functions to specification. The fsr could not duplicate the complaint. A replacement monitor was installed. The unit is operating within manufacturer's specifications. Unit was returned to manufacturer for additional evaluation.
Patient Sequence No: 1, Text Type: N, H10


[80054243] It was reported that during set-up of the device for a cardiopulmonary bypass (cpb) procedure, the display for arterial pressure was not showing any information. They used cardioplegia monitor channel b in place of arterial pressure for this case. The surgical procedure was completed successfully. There was no delay, no blood loss, nor adverse consequences to the patient.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1828100-2017-00300
MDR Report Key6700494
Date Received2017-07-11
Date of Report2017-10-03
Date of Event2017-06-16
Date Mfgr Received2017-09-21
Device Manufacturer Date1994-04-14
Date Added to Maude2017-07-11
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 ContactMS. KATIE HOYT
Manufacturer Street6200 JACKSON ROAD
Manufacturer CityANN ARBOR MI 48103
Manufacturer CountryUS
Manufacturer Postal48103
Manufacturer Phone7346634145
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameSARNS 8000 PERFUSION SYSTEM
Generic NameMONITOR AND/OR CONTROL, LEVEL SENSING, CARDIOPULMONARY BYPASS-SARNS 8000
Product CodeDTW
Date Received2017-07-11
Returned To Mfg2017-06-28
Model Number16413
Catalog Number16413
ID NumberGTIN (01)00886799000205
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerTERUMO CARDIOVASCULAR SYSTEMS CORPORATION
Manufacturer Address6200 JACKSON ROAD ANN ARBOR MI 48103 US 48103


Patients

Patient NumberTreatmentOutcomeDate
10 2017-07-11

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