MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-01-08 for ACROBAT-I POSITIONER XP-5000 manufactured by Maquet Cardiovascular Llc.
[188570022]
Trackwise id # (b)(4). A lot history record review was completed for the reported product lot number. There were no ncmr? S for the reported lot number. Since the device is not available to be returned to us, a technical evaluation cannot be performed. Per our standard sop's, all events are tracked and trended to determine whether or not any trends develope. Device was discarded.
Patient Sequence No: 1, Text Type: N, H10
[188570023]
The hospital reported that during a coronary artery bypass procedure using acrobat-i positioner. They fixed the fixed position and turned the knob, but i couldn't fix it by spinning around. (mechanical issue) a replacement device was used to complete the procedure. The hospital did not report any patient effects.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2242352-2020-00025 |
MDR Report Key | 9565892 |
Report Source | COMPANY REPRESENTATIVE,FOREIG |
Date Received | 2020-01-08 |
Date of Report | 2020-01-07 |
Date of Event | 2019-12-19 |
Date Mfgr Received | 2019-12-19 |
Device Manufacturer Date | 2019-06-17 |
Date Added to Maude | 2020-01-08 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Street | 45 BARBOUR POND DRIVE |
Manufacturer City | WAYNE NJ 07470 |
Manufacturer Country | US |
Manufacturer Postal | 07470 |
Manufacturer G1 | MAQUET CARDIOVASCULAR LLC |
Manufacturer Street | 45 BARBOUR POND DRIVE |
Manufacturer City | WAYNE NJ 07470 |
Manufacturer Country | US |
Manufacturer Postal Code | 07470 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | ACROBAT-I POSITIONER |
Generic Name | STABILIZER, HEART |
Product Code | MWS |
Date Received | 2020-01-08 |
Model Number | XP-5000 |
Catalog Number | XP-5000 |
Lot Number | 25146961 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | N |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | MAQUET CARDIOVASCULAR LLC |
Manufacturer Address | 45 BARBOUR POND DRIVE WAYNE NJ 07470 US 07470 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2020-01-08 |