It was reported that during use of the device for a cardiopulmonary bypass (cpb) procedure, the venous oxygen saturation (svo2) was experiencing abnormally high readings.As a mitigation, after cpb, an alternate device was employed.The surgical procedure was completed successfully.There was no delay, no blood loss, nor adverse consequences to the patient.Per clinical review: the perfusionist reported an incident with their blood parameter monitor (bpm), occurring on numerous cases with multiple units.The units are the only ones that they had put in service.The team was waiting until their data module was available for use to put their bpms in clinical use.The bpm turned on and passed its color chip test without issue for a procedure on (b)(6) 2020.The team initiated cpb and the svo2 was reading close to 100%.The team did an in-vivo and the lab value from the blood gas analyzer was quoted to be between 70 and 80%.The store/recall was performed and the bpm again throughout the case was reading close to 100%, with the patient's svo2 in the 70 and 80's.The perfusionist stated that the discrepancy of readings from actual continued throughout the entire case.Their practice is to do only one venous gas after initiation when the patient is stable.They have had no change in clinical practice or blood gas analyzers.The team exchanged their newer model bpms, and placed the older model bpms back on their heart lung machines (hlms) for clinical use.There was no blood loss, delay in surgical procedure or harm during the occurrence.
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Updated blocks: h3 and h6 the reported complaint could not be confirmed.During blood loop testing, the complaint could not be duplicated.All set points were achieved at 70% and 80% venous oxygen saturation (svo2) prior to an in-vivo, and with set points at 70% and 80% svo2 post in-vivo.These set points were achieved using both 3/8 inch cuvettes and 1/2 inch cuvettes.The service repair technician replaced the hematocrit saturation probe as a precautionary measure.If additional information becomes available on this complaint that would alter the facts and/or conclusion, a supplemental report will be filed accordingly.
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As per end user, there was a 20% differences in saturation with the adult pack with 1/2 cuvette in the venous line and in the smaller pack with the 3/8 venous cuvette.In addition, the end user stated that there was no saturation offset that was set in the device settings.
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