MAUDE Adverse Event Report: Terumo Cardiovascular Systems Corporation Advanced Perfusion System 1; Console, Heart-Lung Machine, Cardiopulmonary Bypass-Advanced Perfusion System 1

Model Number	889773
Medical Device Problem Code	Calibration Problem (2890)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/24/2026
Type of Reportable Event	Malfunction
Event or Problem Description
The manufacturer's subsidiary's service engineer reported that during preventative maintenance (pm) of the device, upon replacement of the oxygen (o2) sensor, the replacement o2 sensor failed calibration.The service engineer reinstalled the original o2 sensor.There was no patient involvement.

• 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 ; +1(734)663-4145
• MDR Report Key: 50788979
• Report Number: 1828100-2026-00281
• Device Sequence Number: 9569986
• Product Code: DTQ
• UDI-Device Identifier: 04250320600725
• UDI-Public: (01)04250320600725(11)260330(17)270930
• Combination Product (Y/N): N
• Initial Reporter Country: MX
• PMA/510(K) Number: K172220
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Other,Foreign,Health Professional,User Facility,Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/16/2026

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: 889773
• Device Catalogue Number: 889773
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 08/24/2026
• Initial Report FDA Received Date: 09/16/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 03/30/2026
• 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: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown