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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: TERUMO CARDIOVASCULAR SYSTEMS CORPORATION SARNS CENTRIFUGAL SYSTEM; CONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS - SARNS CENTRIFUGAL SYSTEM

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TERUMO CARDIOVASCULAR SYSTEMS CORPORATION SARNS CENTRIFUGAL SYSTEM; CONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS - SARNS CENTRIFUGAL SYSTEM Back to Search Results
Model Number 6379
Device Problem Battery Problem (2885)
Patient Problem No Patient Involvement (2645)
Event Date 07/17/2019
Event Type  malfunction  
Event Description
It was reported that during the use of the device for a non-clinical activity, the battery message appeared every five minutes when both switches on the centrifugal module and battery wedge were on.There was no patient involvement.
 
Manufacturer Narrative
The reported complaint could not be verified.Per the field service representative (fsr), the user facility decided to decline the service call and purchase a new unit, hence no evaluation nor repair could be done.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
SARNS CENTRIFUGAL SYSTEM
Type of Device
CONTROL, PUMP SPEED, CARDIOPULMONARY BYPASS - SARNS CENTRIFUGAL SYSTEM
Manufacturer (Section D)
TERUMO CARDIOVASCULAR SYSTEMS CORPORATION
6200 jackson road
ann arbor MI 48103
MDR Report Key8873232
MDR Text Key159869505
Report Number1828100-2019-00422
Device Sequence Number1
Product Code DWA
Combination Product (y/n)N
PMA/PMN Number
K950739
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Type of Report Initial,Followup
Report Date 10/18/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received08/08/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number6379
Device Catalogue Number6379
Was Device Available for Evaluation? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received10/18/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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