ATLAS POSITIONER ATTACHMENT T401261 N/A

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 2020-03-09 for ATLAS POSITIONER ATTACHMENT T401261 N/A manufactured by Terumo Cardiovascular Systems Corporation.

Event Text Entries

[188529905] Terumo has not received the device for evaluation; therefore, the investigation has yet to be completed. Terumo plans on submitting a follow-up report when the investigation is complete and when more information becomes available. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[188529906] During a performance survey the user facility reported to terumo cardiovascular that they stop using the atlas positioner because it frequently tears the epicardium making it difficult to fix the bleeding. No other information about the nature of the event was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1124841-2020-00057
MDR Report Key9808680
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-09
Date of Report2020-03-09
Date Mfgr Received2020-02-17
Date Added to Maude2020-03-09
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPHYSICIAN ASSISTANT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMS. CATHLEEN HARGREAVES
Manufacturer Street125 BLUE BALL ROAD
Manufacturer CityELKTON MD 21921
Manufacturer CountryUS
Manufacturer Postal21921
Manufacturer Phone8002837866
Manufacturer G1SAME
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameATLAS POSITIONER ATTACHMENT
Generic NameUNIVERSAL STABILIZER ARM
Product CodeMWS
Date Received2020-03-09
Model NumberT401261
Catalog NumberN/A
Lot NumberUNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTERUMO CARDIOVASCULAR SYSTEMS CORPORATION
Manufacturer Address125 BLUE BALL ROAD ELKTON MD 21921 US 21921


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-09

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