inforMED
MalfunctionKRL

S5 BUBBLE DETECTOR

Received Apr 12, 2017 · Event occurred Mar 27, 2017

Report 9611109-2017-00290 · MDR key 6485817

Device

Generic name

Monitor And/or Control, Level Sensing, Cardiopulmonary Bypass

Model number

23-07-50

Product problems

  • False Alarm
  • Pumping Stopped
  • False Alarm
  • Pumping Stopped

Patient

Not reported

  • No Consequences Or Impact To Patient
  • No Consequences Or Impact To Patient

Narrative

Additional Manufacturer Narrative

PATIENT INFORMATION WAS NOT PROVIDED. LIVANOVA (B)(4) MANUFACTURES THE S5 BUBBLE DETECTOR. THE INCIDENT OCCURRED IN (B)(6). THIS MEDWATCH REPORT IS BEING FILED ON BEHALF OF LIVANOVA (B)(4). A LIVANOVA FIELD SERVICE REPRESENTATIVE WAS DISPATCHED TO THE FACILITY TO INVESTIGATE. THE SERVICE REPRESENTATIVE TESTED THE DEVICE EXTENSIVELY AND WAS UNABLE TO REPRODUCE THE REPORTED ISSUE. FUNCTIONAL VERIFICATION TESTING WAS SUCCESSFULLY COMPLETED AND THE DEVICE WAS RETURNED TO SERVICE. AS THE ISSUE COULD NOT BE REPRODUCED, A ROOT CAUSE COULD NOT BE DETERMINED. A REVIEW OF THE DHR DID NOT IDENTIFY ANY DEVIATIONS OR NON-CONFORMITIES RELEVANT TO THE REPORTED ISSUE.

Description of Event or Problem

LIVANOVA (B)(4) RECEIVED A REPORT THAT THE S5 BUBBLE DETECTOR GAVE REPEATED FALSE ALARMS AND TRIGGERED MULTIPLE PUMP STOPS DURING A PROCEDURE. THE PROCEDURE WAS COMPLETED WITH A SPARE SENSOR. THERE WAS NO PATIENT INJURY.

Remedial action

  • Other