Archived Perfusion Report - 087

PERFUSION REPORTS

REPORT

087

DATE

1/10/2021

TITLE

Leaking one way valve

DETAILS OF INCIDENT

The one way valve in the LV valve was leaking from the start of the case. The leak was slow and blood loss was minimal-the valve was removed by the perfusionist as soon as the leak was detected.

DETAILS OF INJURY TO PATIENT

N/A

TYPE OF DEVICE/MANUFACTURER

Terumo adult tubing pack

ACTION TAKEN

The leaking one way valve was cut out of the vent using a sterile technique.

Company contacted, have arranged collection of the faulty valve for investigation.

RESPONSE FROM MANUFACTURER

ADDTIONAL INFORMATION

SUPPORTING VISUALS/VIDEO

SUPPORTING DOCUMENT

OTHER PERFUSION
REPORTS

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VIEW
REPORT

REPORT NO

092



1/10/21

Vapourizer Issue

VIEW
REPORT

REPORT NO

091



1/10/21

Oyxgenator Leak

VIEW
REPORT

REPORT NO

090



1/10/21

Breach of chemical cleaner

VIEW
REPORT

REPORT NO

089



1/9/21

Sechrist Gas Blender Sweep on ECMO

VIEW
REPORT

REPORT NO

088



1/9/21

Oxygenator High Pressure Events

VIEW
REPORT

REPORT NO

087



1/10/21

Leaking one way valve

VIEW
REPORT

REPORT NO

086



1/7/21

Electronic Gas Blender Fault

VIEW
REPORT

REPORT NO

085



1/2/21

Protamine Administration Issue

VIEW
REPORT

REPORT NO

084



1/6/21

Damaged roller pump lid

VIEW
REPORT

REPORT NO

083



1/6/21

IABP malfunction

VIEW
REPORT

REPORT NO

082



1/1/21

Accidental cardioplegia administration

VIEW
REPORT

REPORT NO

081



1/4/21

S5 Double Roller Pump incident

VIEW
REPORT

REPORT NO

080



1/5/21

Human factors issue

VIEW
REPORT

REPORT NO

079



1/6/21

Centrimag battery module failure

VIEW
REPORT

REPORT NO

078



1/6/21

Sampling manifold valve fault

VIEW
REPORT

REPORT NO

077



1/5/21

IABP transport issue

VIEW
REPORT

REPORT NO

076



1/4/21

Modified Ultrafiltration (MUF) Issue

VIEW
REPORT

REPORT NO

075



1/3/21

Electromagnetic interference with HLM

VIEW
REPORT

REPORT NO

074



1/2/21

HCU40 Failure

VIEW
REPORT

REPORT NO

073



1/2/21

HCU40 valve failures

VIEW
REPORT

REPORT NO

072



1/1/21

HCU40 failure

VIEW
REPORT

REPORT NO

071



1/1/21

LIVA NOVA STATEMENT ON CENTRIFUGAL HEAD

VIEW
REPORT

REPORT NO

070



1/1/21

Loose component on circuit

VIEW
REPORT

REPORT NO

069



1/12/20

Centrifugal Head noise

VIEW
REPORT

REPORT NO

068



1/11/20

Venous Reservoir disposable issue

VIEW
REPORT

REPORT NO

067



1/11/20

Failure of Heater Cooler due to leaking valves

VIEW
REPORT

REPORT NO

066



1/11/20

Failure of Valves on heater cooler unit

VIEW
REPORT

REPORT NO

065



1/9/20

Intra Aortic Balloon Pump (IABP) Failure

VIEW
REPORT

REPORT NO

064



1/9/20

Centrifugal head failure

VIEW
REPORT

REPORT NO

063



1/8/20

Centrifugal head issue 4

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PERFUSION REPORTS

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REPORTS

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OTHER PERFUSION REPORTS

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