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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: TERUMO CARDIOVASCULAR SYSTEMS CORPORATION ADVANCED PERFUSION SYSTEM 1; CONSOLE, HEART-LUNG MACHINE, CARDIOPULMONARY BYPASS-ADVANCED PERFUSION SYSTEM 1

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TERUMO CARDIOVASCULAR SYSTEMS CORPORATION ADVANCED PERFUSION SYSTEM 1; CONSOLE, HEART-LUNG MACHINE, CARDIOPULMONARY BYPASS-ADVANCED PERFUSION SYSTEM 1 Back to Search Results
Model Number 6382
Medical Device Problem Code Unable to Obtain Readings (1516)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 06/18/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the flow probe was not reading.There were no reported consequences to the patient.No other details regarding the nature of this event were provided.
 
Additional Manufacturer Narrative
The field service representative (fsr) replaced the flow sensor.The unit operated to the manufacturer's specifications.
 
Additional Manufacturer Narrative
Updated blocks: d4, d9 and h4.
 
Additional Manufacturer Narrative
Updated block: h6.The reported complaint was confirmed.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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Brand Name
ADVANCED PERFUSION SYSTEM 1
Common Device Name
CONSOLE, HEART-LUNG MACHINE, CARDIOPULMONARY BYPASS-ADVANCED PERFUSION SYSTEM 1
Manufacturer (Section D)
TERUMO CARDIOVASCULAR SYSTEMS CORPORATION
6200 jackson road
ann arbor MI 48103
Manufacturer (Section G)
SAME
Manufacturer Contact
douglas patton
6200 jackson road
ann arbor, MI 48103
7346634145
MDR Report Key22728110
Report Number1828100-2025-00195
Device Sequence Number8344987
Product Code DTQ
UDI-Device Identifier00886799000083
UDI-Public(01)00886799000083(11)241210
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K172220
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup,Followup
Report Date (Section B) 10/01/2025
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 Number6382
Device Catalogue Number6382
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/18/2025
Supplement Date Received by Manufacturer08/11/2025
09/10/2025
Initial Report FDA Received Date08/06/2025
Supplement Report FDA Received Date09/02/2025
10/01/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/10/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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