SMARTPUMP DUAL CHANNEL 5920011000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a user facility report with the FDA on 2020-02-18 for SMARTPUMP DUAL CHANNEL 5920011000 manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[181833259] It was reported that during a surgical procedure at the user facility, the side deflated when the other side was released. The procedure was completed successfully without a clinically significant delay; there were no adverse consequences or medical intervention.
Patient Sequence No: 1, Text Type: D, B5


[188145425] Device evaluation: follow-up report submitted to document device evaluation results.
Patient Sequence No: 1, Text Type: N, H10


[188145426] It was reported that during a surgical procedure at the user facility, the side deflated when the other side was released. The procedure was completed successfully without a clinically significant delay; there were no adverse consequences or medical intervention.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001811755-2020-00503
MDR Report Key9722252
Report SourceUSER FACILITY
Date Received2020-02-18
Date of Report2020-02-18
Date of Event2020-01-30
Date Mfgr Received2020-02-03
Date Added to Maude2020-02-18
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. ZACH BAKER
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal49001
Manufacturer Phone2693237700
Manufacturer G1STRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal Code49001
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSMARTPUMP DUAL CHANNEL
Generic NameTOURNIQUET, PNEUMATIC
Product CodeKCY
Date Received2020-02-18
Model Number5920011000
Catalog Number5920011000
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-18

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