inforMED
MalfunctionMNJ

VACUUM RELIEF VALVE IIC-CLEAR

Received May 16, 2006 · Event occurred Apr 28, 2006

Report 1649914-2006-00047 · MDR key 717926

Device

Generic name

Vacuum Relief Valve

Model number

4004103

Catalog number

*

Lot number

25259.C11

Product problems

  • Fluid/Blood Leak
  • Replace
  • Valve(s), defective

Patient

UNKNOWN

  • Blood Loss

Narrative

Description of Event or Problem

WHILE GIVING CARDIOPLEGIA, THE SURGEON NOTICED THAT THE HEART WAS NOT STOPPING. THE SURGEON REQUESTED INCREASED CARDIOPLEGIA AND THEN NOTICED BLOOD ON FLOOR. THE PERFUSIONIST CHECKED THE CIRCUIT AND NOTED BLOOD AROUND VALVE. THE VALVE WAS REPLACED AND NO FURTHER INCIDENTS WERE REPOATED. THE PRODUCT WAS SAVED AND WILL BE RETURNED. PRODUCT CODE 400103, LOT NUMBER IS EITHER 25259.C11 OR 25775.E09

Additional Manufacturer Narrative

ADDITIONAL LOT# 25775.E09, ADDITIONAL EXP DATE: 01/30/2009.