| Brand Name | QUANTUM ROLLER PUMP - 8 INCH |
| Common Device Name | CARDIOPULMONARY BYPASS SYSTEM ROLLER PUMP |
| Manufacturer (Section D) |
| SPECTRUM MEDICAL LTD |
| ashville business park |
| commerce road |
| gloucester, gloucestershire GL2 9 SL |
| UK GL2 9SL |
|
| Manufacturer (Section G) |
| SPECTRUM MEDICAL LTD |
| ashville business park |
| commerce road |
| gloucester, gloucestershire GL2 9 SL |
|
UK
GL2 9SL
|
|
| Manufacturer Contact |
|
raffaella
tommasini
|
| ashville business park |
| commerce road |
| gloucester, gloucestershire GL2 9-SL
|
|
UK
GL2 9SL
|
|
| MDR Report Key | 24728609 |
| Report Number | 3006073153-2026-00104 |
| Device Sequence Number | 10191580 |
| Product Code |
DTQ
|
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K173834 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Remedial Action |
Replace |
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
03/30/2026 |
| 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 Number | QRP8 |
| Device Catalogue Number | 51-000008-00 |
| Was Device Available for Evaluation? |
Device Returned to Manufacturer
|
| Is the Reporter a Health Professional? |
Yes
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 03/17/2026 |
| Supplement Date Received by Manufacturer | 03/17/2026
|
| Initial Report FDA Received Date | 03/30/2026 |
| Supplement Report FDA Received Date | 06/04/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 01/17/2025 |
| 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 Number | 1 |
| Outcome Attributed to Adverse Event |
Required Intervention;
|
| Patient Sex | Unknown |