MAUDE Adverse Event Report: PERFUSION SYSTEMS BIO CONSOLE 560; CONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS

Model Number 560BCS

Device Problems Device Alarm System (1012); Power Problem (3010)

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

Event Date 02/23/2022

Event Type  malfunction  

Manufacturer Narrative

Product analysis: during preventive maintenance by a field service technician, the service technician observed that when the instrument was turned on it displayed a clamp error when no clamp was connected and had the following error codes logged in memory, 5, 6, 7, 8, 31, 98.The service technician also noted that the power supply output was giving fluctuating voltages from 29 vdc to 31 vdc.The issues were resolved by replacing the power supply.Preventive maintenance was completed per specifications.If information is provided in the future, a supplemental report will be issued.

Event Description

During preventive maintenance of this bio-console base instrument, the field service technician observed that when the instrument was turned on it displayed a clamp error when no clamp was connected and had the following error codes logged in memory, 5, 6, 7, 8, 31, 98.The service technician also noted that the power supply output was giving fluctuating voltages from 29 vdc to 31 vdc.This was detected during service so there was no adverse patient effect.

• Brand Name: BIO CONSOLE 560
• Type of Device: CONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS
• Manufacturer (Section D): PERFUSION SYSTEMS; 7611 northland dr; brooklyn park MN 55428
• Manufacturer (Section G): PERFUSION SYSTEMS; 7611 northland dr; brooklyn park MN 55428
• Manufacturer Contact: alison sweeney ; parkmore business park west; galway ; EI ; 091708096
• MDR Report Key: 13869213
• MDR Text Key: 289270003
• Report Number: 2184009-2022-00045
• Device Sequence Number: 1
• Product Code: DWA
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K080824
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Company Representative
• Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date: 03/23/2022

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 Operator: Health Professional
• Device Model Number: 560BCS
• Device Catalogue Number: 560BCS
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 02/23/2022
• Initial Date FDA Received: 03/23/2022
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 11/17/2005
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Unknown
• Patient Sequence Number: 1