BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VENTRASSIST

    MDR report key: 1293973 · Received January 21, 2009

    Report

    Report Number
    MW5009705
    Event Type
    Injury
    Date Received
    January 21, 2009
    Date of Event
    January 20, 2009
    Report Date
    January 21, 2009
    Manufacturer
    VENTRACOR INC
    Product Code
    DSQ
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    VENTRASSIST VAD PLACED. ELECTRICAL PUMP FAILURE YESTERDAY. PUMP REPLACED TODAY. DEVICE TAKEN BY VAD COORD. FAILED MEDICAL DEVICE COMPLETED AND FAXED TO RISK MGMT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VENTRASSIST VENTRASSIST VAD DSQ VENTRACOR INC

    Patients

    Seq Age Sex Outcome Treatment
    1 71 YR Disability