MAUDE MDR 9885524

MDR report key
9885524
Report number
2249723-2020-00504
Event key
0
Event type
3
Date of event
2020-03-04
Date received
2020-03-26
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Address
1300 MACARTHUR BLVD MAHWAH NJ 07430 US
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1CARDIOSAVE HYBRID TYPE B PLUGSYSTEM, BALLOON, INTRA-AORTIC AND CONTROLDATASCOPE CORP. - MAHWAHDSPN/A0998-00-0800-53N/AY Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-03-260

Event Narratives#

N

Patient 1

THE PRODUCTION DEVICE HISTORY RECORD (DHR) FOR THIS INTRA-AORTIC BALLOON PUMP (IABP) WAS NOT REQUIRED TO BE REVIEWED AS PER COMPANY STANDARD OPERATING PROCEDURE SINCE THE DEVICE MANUFACTURE DATE IS GREATER THAN ONE YEAR FROM THE EVENT DATE. (B)(6). THE GETINGE FIELD SERVICE ENGINEER (FSE) THAT ENCOUNTERED THE ISSUE SUSPECTED LEAKS FROM FILL MANIFOLD AND THEN DRIVE MANIFOLD, SO BOTH WERE REPLACED. THE FSE REPLACED THE DRIVE MANIFOLD PRESSURE TRANSDUCER SUSPECTING THAT A FALSE READING WAS BEING SENT. THE FSE FOUND THAT THE SOLENOID COULD BE MANUALLY MANIPULATED TO DRAW VACUUM AND THAT K10 WAS NOT FUNCTIONING CORRECTLY DURING VACUUM AND PRESSURE STAGES. THE FSE REPLACED THE SOLENOID CONTROL BOARD AND REMEDIED THE ISSUE. THE FSE THEN PERFORMED AND COMPLETED A PREVENTIVE MAINTENANCE WITH ALL CALIBRATION, FUNCTIONAL AND SAFETY CHECKS TO MEET FACTORY SPECIFICATIONS. UNIT PASSED ALL CALIBRATION, FUNCTIONAL AND SAFETY TEST PER FACTORY SPECIFICATIONS. THE IABP WAS THEN RELEASED TO THE CUSTOMER AND CLEARED FOR CLINICAL SERVICE.

D

Patient 1

IT WAS REPORTED THAT DURING A PREVENTIVE MAINTENANCE (PM) PERFORMED BY A GETINGE FIELD SERVICE ENGINEER, THE CARDIOSAVE INTRA-AORTIC BALLOON PUMP (IABP) HAD AN AUTOFILL WITH FAULT #37. THERE WAS NO PATIENT INVOLVEMENT, AND NO ADVERSE EVENT REPORTED.