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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 801188
Medical Device Problem Code Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/14/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the electronic patient gas system (epgs) readings were fluctuating on the central control monitor (ccm) display.The surgical procedure was completed successfully.There was no delay, no blood loss, nor adverse consequences to the patient.
 
Additional Manufacturer Narrative
The field service representative (fsr) found that the system passed calibration upon arrival.The fsr ran gas system testing but was not able to observe any fluctuations.The onscreen readings read low compared to the oxygen (o2) tester and on screen setpoints.The fsr replaced the o2 sensor and performed release testing.The unit operated to the manufacturer's specifications.
 
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 Key24261054
Report Number1828100-2026-00018
Device Sequence Number13161893
Product Code DTQ
UDI-Device Identifier00886799000588
UDI-Public(01)00886799000588(11)220219
Combination Product (Y/N)N
Initial Reporter StateWI
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
Report Date (Section B) 03/25/2026
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 Number801188
Device Catalogue Number801188
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/27/2026
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 01/14/2026
Supplement Date Received by Manufacturer03/03/2026
Initial Report FDA Received Date02/04/2026
Supplement Report FDA Received Date03/25/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/19/2022
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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