TANDEMHEART PUMP 5120-0000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-11 for TANDEMHEART PUMP 5120-0000 manufactured by Cardiacassist Inc..

Event Text Entries

[188700470] It was reported that within minutes of beginning support the perfusionist reported that the flow dropped from 4l to 2l and eventually 0l while the patient was on the or table. The pump and oxygenator were exchanged. Device history records were reviewed for the returned pump and oxygenator. Both were reviewed and no conformities or abnormalities were found. The pump and oxygenator were received by the manufacturer for product analysis. When the pump was returned a thrombus was evident on the impeller vanes and the current draw values were higher than specified, potentially due to the thrombus observed. It cannot be determined whether the thrombus was present during use in the field, or whether it was a result of return shipping conditions. During internal visual inspection of the pump lower housing and journal bores, particulate was found which may indicate improper priming of the pump during use. The drop in flow was likely due to an increased resistance of the oxygenator due to thrombus formation. No further relevant information has been received to date.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2531527-2020-00014
MDR Report Key9820087
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-11
Date of Report2020-03-11
Date of Event2020-01-23
Date Mfgr Received2020-01-23
Date Added to Maude2020-03-11
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMRS. NJEMILE CRAWLEY
Manufacturer Street620 ALPHA STREET
Manufacturer CityPITTSBURGH PA 15238
Manufacturer CountryUS
Manufacturer Postal15238
Manufacturer Phone2812287200
Manufacturer G1CARDIACASSIST, INC.
Manufacturer Street620 ALPHA DRIVE
Manufacturer CityPITTSBURGH PA 15238
Manufacturer CountryUS
Manufacturer Postal Code15238
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameTANDEMHEART PUMP
Generic NameNON-ROLLER TYPE BLOOD PUMP
Product CodeKFM
Date Received2020-03-11
Model Number5120-0000
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerCARDIACASSIST INC.
Manufacturer Address620 ALPHA DRIVE PITTSBURGH PA 15238 US 15238


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-11

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