FDA Adverse Event Malfunction Summary report: N

10 MM HEMASHIELD ARTERIAL CANNULA

MDR report key: 1013995 · Received March 13, 2008

Report

Report Number
1220648-2008-00002
Event Type
Malfunction
Date Received
March 13, 2008
Date of Event
February 2, 2008
Report Date
March 11, 2008
Manufacturer
ABIOMED, INC.
Product Code
DSQ
PMA / PMN Number
P900023
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PATIENT EXPIRED IN 2008 DUE TO MULTI-SYMPTOM ORGAN FAILURE (MSOF), WHICH WAS UNRELATED TO BLEEDING THROUGH HEMASHIELD. GRAFT WAS NOT RETRIEVED. UAB HAS NOT COOPERATED WITH ABIOMED IN PROVIDING CANNULA LOT NUMBERS. ABIOMED WILL CONTINUE TO REQUEST THIS INFORMATION. RESULTS AND CONCLUSIONS WILL BE SUMMARIZED IN FOLLOW-UP / FINAL REPORT.

Description of Event or Problem · 1

SURGEON REPORTED EXCESSIVE BLEEDING THROUGH HEMASHIELD ARTERIAL GRAFT AND HAD TO COVER GRAFT WITH A SECOND BOSTON SCIENTIFIC GRAFT TO STOP THE BLEEDING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 10 MM HEMASHIELD ARTERIAL CANNULA CARDIAC ASSIST DSQ ABIOMED, INC. TBD

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention