SARNS 8000 PERFUSION SYSTEM 195274

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2018-07-23 for SARNS 8000 PERFUSION SYSTEM 195274 manufactured by Terumo Cardiovascular Systems Corporation.

Event Text Entries

[114809988] Evaluation is in progress, but not yet concluded. The user turned the level sensors off and completed the case without incident.
Patient Sequence No: 1, Text Type: N, H10


[114809989] It was reported that during use of the device for a cardiopulmonary bypass (cpb) procedure, the low level alarm was sounding intermittently while there was no low level condition present. 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 Number1828100-2018-00382
MDR Report Key7712445
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2018-07-23
Date of Report2018-09-11
Date of Event2018-06-29
Date Mfgr Received2018-08-20
Device Manufacturer Date2008-11-18
Date Added to Maude2018-07-23
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 ContactMR. DOUGLAS PATTON
Manufacturer Street6200 JACKSON ROAD
Manufacturer CityANN ARBOR MI 48103
Manufacturer CountryUS
Manufacturer Postal48103
Manufacturer Phone7346634145
Manufacturer G1SAME
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSARNS 8000 PERFUSION SYSTEM
Generic NameMONITOR AND/OR CONTROL, LEVEL SENSING, CARDIOPULMONARY BYPASS-SARNS 8000
Product CodeDTW
Date Received2018-07-23
Returned To Mfg2018-07-09
Model Number195274
Catalog Number195274
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 2018-07-23

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