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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DATASCOPE CORP. LINEAR 7.5FR. 34CC IAB (INDIA); SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL

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DATASCOPE CORP. LINEAR 7.5FR. 34CC IAB (INDIA); SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL Back to Search Results
Model Number 0684-00-0479-07
Medical Device Problem Code Pressure Problem (3012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/26/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Due to characterization limit e1: initial reporter: dr.(b)(6).Event site name: (b)(6) hospital.Event site address: (b)(6).The device has not been returned to the manufacturer so we are unable to complete an evaluation.If provided we will send a supplemental report with our additional findings.Complaint record id (b)(4).
 
Event or Problem Description
It was reported that linear 7.5fr.34cc intra-aortic balloon pump (iabp) had failure in balloon augmentation.
 
Additional Manufacturer Narrative
Updated fields: b4, g3, g6, h2, h11.Corrected fields: b5, h6 (investigation finding).
 
Event or Problem Description
It was reported that linear 7.5fr.34cc intra aortic balloon pump (iabp) had failure in balloon augmentation.There was no harm reported.
 
Additional Manufacturer Narrative
Updated fields: b4, d9, g3, g6, h2, h3, h6 (type of investigation, investigation findings and investigation conclusions), h11.No decon or visual inspection performed since product was not returned and could not be evaluated.Therefore, we were unable to confirm or determine a root cause for the reported failure.The failure mode is addressed in the risk file and is operating within its risk profile.The ifu addresses the reported failure.There were no ncmrs identified which could cause or contribute to the reported failure.The investigation does not indicate that the device was inadvertently released as non-conforming or an adulterated product or was a counterfeit.The complaint history review did not identify an adverse trend (increase in number of complaints over past three (3) months).Based on the rational provided above, no escalation to the capa process is required.
 
Event or Problem Description
N/a.
 
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Brand Name
LINEAR 7.5FR. 34CC IAB (INDIA)
Common Device Name
SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL
Manufacturer (Section D)
DATASCOPE CORP.
15 law drive
fairfield NJ 07004
Manufacturer (Section G)
DATASCOPE CORP.
15 law drive
fairfield NJ 07004
Manufacturer Contact
ewelina chorlowska
15 law drive
fairfield, NJ 07004
MDR Report Key24159210
Report Number2248146-2026-0000513
Device Sequence Number9020073
Product Code DSP
UDI-Device Identifier10607567109695
UDI-Public(01)10607567109695(10)3000436707(17)271212(11)241212
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
K041281
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/26/2026
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 Number0684-00-0479-07
Device Catalogue Number0684-00-0479-07
Device Lot Number3000436707
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/30/2025
Supplement Date Received by Manufacturer02/21/2026
02/26/2026
Initial Report FDA Received Date01/23/2026
Supplement Report FDA Received Date02/23/2026
02/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/12/2024
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
UNKNOWN.
Patient Age70 YR
Patient SexFemale
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