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 health professional report with the FDA on 2020-03-25 for TANDEMHEART PUMP 5120-0000 manufactured by Cardiacassist Inc..

Event Text Entries

[188007038] Patient information was not provided. Serial number is unknown. This information will be provided in a supplemental report if made available. As the serial number is unknown, the device manufacture date could not be determined. This information will be provided in a supplemental report if made available. Cardiacassist inc. Manufactures the tandemheart pump. The incident occurred in (b)(6). Investigation is in progress. If any additional information pertinent to the reported event is received, it will be provided in a supplemental report.
Patient Sequence No: 1, Text Type: N, H10


[188007039] Cardiacassist received a report about a sudden stop of the tandemheart pump displaying an error message "low flow" during procedure and it required replacement of the device. The patient desatted to the 20%. After pump replaced saturation went back to the 80% where they were previously. The patient required increased vent support.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2531527-2020-00015
MDR Report Key9878018
Report SourceHEALTH PROFESSIONAL
Date Received2020-03-25
Date of Report2020-02-26
Date of Event2020-02-26
Date Mfgr Received2020-02-26
Date Added to Maude2020-03-25
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 ContactENRICO GRECO
Manufacturer Street620 ALPHA DRIVE
Manufacturer CityPITTSBURGH PA 15238
Manufacturer CountryUS
Manufacturer Postal15238
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 Received2020-03-25
Model Number5120-0000
Catalog Number5120-0000
OperatorHEALTH PROFESSIONAL
Device Availability*
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerCARDIACASSIST INC.
Manufacturer Address620 ALPHA DRIVE PITTSBURGH PA 15238 US 15238


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-25

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