CENTRIMAG 2ND GENERATION PRIMARY CONSOLE 201-30300

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a foreign,health professional report with the FDA on 2020-02-24 for CENTRIMAG 2ND GENERATION PRIMARY CONSOLE 201-30300 manufactured by Thoratec Switzerland Gmbh.

Event Text Entries

[182444429] The associated centrimag 2nd generation primary console, sn: unknown is reported under mfr # 2916596-2020-00893 and the associated centrimag motor, ous, sn: (b)(4) is reported under mfr # 2916596-2020-00892. The device is expected to be returned for evaluation. It has not yet been received. No further information was provided. A supplemental report will be submitted when the manufacturer? S investigation is completed.
Patient Sequence No: 1, Text Type: N, H10


[182444430] It was reported that there was an s3 alert on the console while the system was in use on a patient in an ambulance en-route to the hospital. There was also no flow probe reading. The back-up console was attached and initially got a reading. However, then the same s3 alert appeared and the flow probe did not have a reading. The device was detached from the ambulance power supply and turned off and on. Following that the flow probe worked fine for the duration of the journey. There were no adverse patient effects. No further information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2916596-2020-00891
MDR Report Key9748437
Report SourceFOREIGN,HEALTH PROFESSIONAL
Date Received2020-02-24
Date of Report2020-02-24
Date of Event2019-08-10
Date Mfgr Received2020-01-28
Date Added to Maude2020-02-24
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. BOB FRYC
Manufacturer Street6035 STONERIDGE DRIVE
Manufacturer CityPLEASANTON CA 94588
Manufacturer CountryUS
Manufacturer Postal94588
Manufacturer Phone7818528204
Manufacturer G1THORATEC SWITZERLAND GMBH
Manufacturer StreetTECHNOPARKSTRASSE 1
Manufacturer CityZURICH CH-8005
Manufacturer CountrySZ
Manufacturer Postal CodeCH-8005
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameCENTRIMAG 2ND GENERATION PRIMARY CONSOLE
Generic NameCONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS
Product CodeDWA
Date Received2020-02-24
Model Number201-30300
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTHORATEC SWITZERLAND GMBH
Manufacturer AddressTECHNOPARKSTRASSE 1 ZURICH CH-8005 SZ CH-8005


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-24

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