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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DATASCOPE CORP. CS100 INTRA-AORTIC BALLOON PUMP, ITALIAN, 220V; SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL

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DATASCOPE CORP. CS100 INTRA-AORTIC BALLOON PUMP, ITALIAN, 220V; SYSTEM, BALLOON, INTRA-AORTIC AND CONTROL Back to Search Results
Model Number 0998-00-3013-67
Medical Device Problem Codes Display or Visual Feedback Problem (1184); Poor Quality Image (1408)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/12/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
A supplemental report will be submitted upon completion of our investigation.
 
Event or Problem Description
It was reported that the cs100 intra aortic balloon pump (iabp) had display image anomaly, unstable vision before use.There was no patient involved.
 
Event or Problem Description
N/a.
 
Additional Manufacturer Narrative
Updated fields- b4, g3, g6, h1, h2, h6 (type of investigation, investigation findings, component codes, investigation conclusions), h11 a getinge field service engineer (fse) was dispatched to evaluate the unit.The (fse) reported that cleaning contacts on the control panel resolved the reported issue.Functional tests were performed successfully.
 
Event or Problem Description
N/a.
 
Additional Manufacturer Narrative
Updated data: b4, g3, g6, h1, h2, h11.Corrected data: h6 (medical device ¿ problem code, investigation findings).
 
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Brand Name
CS100 INTRA-AORTIC BALLOON PUMP, ITALIAN, 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 Key24762398
Report Number2249723-2026-0001987
Device Sequence Number10299761
Product Code DSP
UDI-Device Identifier10607567107486
UDI-Public(01)10607567107486
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
K031636
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Company Representative
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup,Followup
Report Date (Section B) 04/15/2026
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 Number0998-00-3013-67
Device Catalogue Number0998-00-3013-67
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 03/12/2026
Supplement Date Received by Manufacturer04/07/2026
04/15/2026
Initial Report FDA Received Date04/02/2026
Supplement Report FDA Received Date04/09/2026
04/15/2026
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
Concomitant Medical Products
and Therapy/Usage Dates
N/A.
Patient SexUnknown
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