MAUDE Adverse Event Report: CARDIOQUIP LLC CARDIOQUIP MODULAR COOLER HEATER; CARDIOPULMONARY BYPASS DEVICE

Model Number MCH-1000(I)

Device Problem Microbial Contamination of Device (2303)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 04/09/2024

Event Type  malfunction  

Event Description

Cq service was notified via phone call that the customer identified potential contamination in the internal tubing of this device.The customer took pictures and forwarded them to cardioquip for review.Cq director of operations and epidemiologist reviewed the pictures from the customer and recommended that the customer perform a quarterly cleaning and disinfection procedure per the ifu as well as hpc testing to gain a quantitative assessment of water quality.Hpc testing confirmed bacterial counts to be outside cardioquip specifications on (b)(6) 2024.

Manufacturer Narrative

A cardioquip customer submitted photos of tubing to epidemiology.Due to the discoloration of the tubing, epidemiology recommended that the device receive hpc testing to provide a quantitative assessment of water quality.Following test results outside of cardioquip specifications, cardioquip recommended that either, (1) the customer reperform cleaning and disinfection procedures detailed in the ifu and reperform hpc testing, (2) have the device receive an internal water pathway replacement or, (3) participate in cardioquip's trade in program.The customer choose to perform an internal water pathway to repair the device.The device has arrived at cardioquip facilities and is currently awaiting service.Once the service has been completed the device will be returned to specification and fully functional.

• Brand Name: CARDIOQUIP MODULAR COOLER HEATER
• Type of Device: CARDIOPULMONARY BYPASS DEVICE
• Manufacturer (Section D): CARDIOQUIP LLC; 8422 calibration ct.; college station TX 77845
• Manufacturer (Section G): CARDIOQUIP LLC; 8422 calibration ct.; college station TX 77845
• Manufacturer Contact: charley ford ; 8422 calibration ct.; college station, TX 77845
• MDR Report Key: 19217839
• MDR Text Key: 341804651
• Report Number: 3007899424-2024-00062
• Device Sequence Number: 1
• Product Code: DWC
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K102147
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Other
• Reporter Occupation: Non-Healthcare Professional
• Remedial Action: Inspection
• Type of Report: Initial
• Report Date: 04/11/2024

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Model Number: MCH-1000(I)
• Was Device Available for Evaluation?: Yes
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 04/30/2024
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 01/30/2017
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1