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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DATASCOPE CORP. CS300 INTRA-AORTIC BALLOON PUMP, PORTUGUESE, 220V; SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL

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DATASCOPE CORP. CS300 INTRA-AORTIC BALLOON PUMP, PORTUGUESE, 220V; SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL Back to Search Results
Model Number 0998-00-3023-68
Medical Device Problem Code Inability to Auto-Fill (1044)
Health Effect - Clinical Codes Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/24/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Updated fields: b3, b4, d8, d9 (device available for eval), e2, e3, e4, g1(contact person ¿ mfg site), g3, g6, h2, h3, h6(type of investigation, investigation findings, component codes, investigation conclusions), h11.Corrected field: d10 (concomitant products).A getinge field service engineer (fse) was dispatched to evaluate the unit.Fse states, displacement to verify the anomaly.Equipment presents autofill error.Equipment with blood detector damaged.Replaced tubing, blood detect, iabp.Functional tests.Equipment suitable for clinical use.
 
Event or Problem Description
N/a.
 
Additional Manufacturer Narrative
Updated fields: b4, e1(initial reporter, event site email), g3, g6, h2, h6(investigation conclusions), h11.
 
Event or Problem Description
N/a.
 
Additional Manufacturer Narrative
Updated fields- b4, b5, g3, g6, h2, h11 corrected fields-e1 (event site telephone, initial reporter name).
 
Additional Manufacturer Narrative
A supplemental report will be submitted upon completion of our investigation.Due to character limitation in e1 for event site address: (b)(6).
 
Event or Problem Description
It was reported that before use, the cs300 intra-aortic balloon pump (iabp) unit had an autofill failure issue.There was no patient involvement reported.
 
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Brand Name
CS300 INTRA-AORTIC BALLOON PUMP, PORTUGUESE, 220V
Common Device Name
SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL
Manufacturer (Section D)
DATASCOPE CORP.
1300 macarthur blvd
mahwah NJ 07430
Manufacturer (Section G)
DATASCOPE CORP.
1300 macarthur blvd
mahwah NJ 07430
Manufacturer Contact
ewelina chorlowska
1300 macarthur blvd
mahwah, NJ 07430
MDR Report Key22724682
Report Number2249723-2025-0003387
Device Sequence Number8884484
Product Code DSP
UDI-Device Identifier10607567108353
UDI-Public(01)10607567108353
Combination Product (Y/N)N
Initial Reporter CountryPO
PMA/510(K) Number
K063525
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup,Followup
Report Date (Section B) 09/22/2025
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
Operator of Device Health Professional
Device Model Number0998-00-3023-68
Device Catalogue Number0998-00-3023-68
Was Device Available for Evaluation? Yes
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/24/2025
Supplement Date Received by Manufacturer08/18/2025
09/19/2025
09/19/2025
Initial Report FDA Received Date08/06/2025
Supplement Report FDA Received Date08/22/2025
09/19/2025
09/22/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Is the Device Labeled for Single Use? (Y/N) No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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