FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO 2

MDR report key: 13170525 · Received January 5, 2022

Report

Report Number
2242352-2022-00013
Event Type
Malfunction
Date Received
January 5, 2022
Date of Event
December 7, 2021
Report Date
May 4, 2022
Manufacturer
MAQUET CARDIOVASCULAR LLC
Product Code
GEI
UDI-DI
00607567700864
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DA
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

TRACKWISE #(B)(4). THE DEVICE HAS NOT YET BEEN RETURNED TO MAQUET CARDIAC SURGERY FOR EVALUATION. WE ARE FOLLOWING UP WITH THE CUSTOMER FOR THE RETURN OF THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED.

Additional Manufacturer Narrative · 0

CORRECTED SECTION: H-3 DEVICE NOT EVAL PROVIDE CODE: FROM "OTHER" TO "DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN." TRACKWISE ID # (B)(4). THE DEVICE HAS BEEN RETURNED TO THE FACTORY AND IS BEING EVALUATED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETED.

Additional Manufacturer Narrative · 0

TRACKWISE # (B)(4). ANALYSIS OF PRODUCTION: (3331/2130/67) THE DEVICE HISTORY RECORDS REVIEW CONCLUDED THAT THERE WERE NO NCMRS, REWORK, OR DEVIATIONS DOCUMENTED FOR THE REPORTED LOT NUMBER. BASED ON THE DHR/LHR REVIEW RESULTS, IT WAS DETERMINED THAT THERE IS NO RELATION BETWEEN THE MANUFACTURING PROCESS AND THE REPORTED FAILURE. HISTORICAL DATA ANALYSIS: (4109/213/67) THE REVIEW OF THE HISTORICAL DATA INDICATES THAT NO OTHER SIMILAR COMPLAINTS WAS REPORTED FOR THE SAME LOT NUMBER AND REPORTED FAILURE MODE. TREND ANALYSIS: (4110/213/67) THE OVERALL 24 MONTH PRODUCT COMPLAINT TREND DATA FOR THE PERIOD JAN 2020 TO DEC 2021 WAS REVIEWED. THERE WERE NO TRIGGERS IDENTIFIED FOR THE REVIEW PERIOD. COMMUNICATION/INTERVIEWS: (4111/213/67) COMMUNICATION/INTERVIEWS WERE PERFORMED TO OBTAIN ALL POSSIBLE INFORMATION. TESTING OF ACTUAL/SUSPECTED DEVICE & TESTING OF RAW/STARTING MATERIALS: (10/213/67) THE DEVICE WAS RETURNED TO THE FACTORY FOR EVALUATION ON 01/31/2022. AN INVESTIGATION WAS CONDUCTED ON 05/02/2022. A VISUAL INSPECTION WAS CONDUCTED. A PHOTOGRAPH WAS PROVIDED BY THE ACCOUNT. A PHOTOGRAPHIC INSPECTION WAS CONDUCTED. THE PRODUCT AND LOT # WERE OBSERVED IN THE PHOTOGRAPH. SIGNS OF CLINICAL USE AND SLIGHT EVIDENCE OF BLOOD WAS OBSERVED ON THE INTACT JAWS. THE CLEAR SILICONE INSULATION ON BOTH THE COLD AND HOT JAWS WAS OBSERVED TO BE INTACT, NO VISUAL DEFECTS WERE OBSERVED. THE HEATER WIRE WAS OBSERVED TO BE INTACT, WITH NO VISUAL DEFECTS OBSERVED. AN ELECTRICAL EVALUATION WAS CONDUCTED. A PRE-CAUTERY TEST WAS PERFORMED PER THE INSTRUCTION FOR USE (IFU) WITH A REFERENCE CABLE, ADAPTER AND REFERENCE POWER SUPPLY VH-3010 AT LEVEL 3.0. THE DEVICE PASSED THE PRE-CAUTERY TEST. IT PRODUCED VISIBLE STEAM AND HEAT DURING TEN (10) 3-SECOND ACTIVATIONS AND SHUT OFF WHEN THE TOGGLE WAS RELEASED. A TONE WAS AUDIBLE FROM THE POWER SUPPLY UPON ACTIVATION. TO EVALUATE THE SAFETY SHUT DOWN SYSTEM, A POLYFUSE ACTIVATION TEST WAS PERFORMED 5 TIMES OVER 10 MINUTES. THE DEVICE SHUT OFF AFTER THE PERIOD OF SUSTAINED ACTIVATION AND REACTIVATED AFTER 10-SECOND COOLING PERIOD WITH NO INCIDENT EACH TIME. BASED ON THE RETURNED CONDITION OF THE DEVICE, THE REPORTED FAILURE "ELECTRICAL /ELECTRONIC PROPERTY PROBLEM" WAS NOT CONFIRMED.

Additional Manufacturer Narrative · 0

TRACKWISE ID # (B)(4). THE DEVICE HAS NOT YET BEEN RETURNED TO MAQUET CARDIAC SURGERY FOR EVALUATION. WE ARE FOLLOWING UP WITH THE CUSTOMER FOR THE RETURN OF THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED.

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, VASOVIEW HEMOPRO 2 WAS NOT BURNING/COAGULATING WHEN FUNCTION WERE ACTIVATED. THE CASE WAS COMPLETED WITH A NEW GETINGE HEMOPRO II DEVICE. NO HARM TO PATIENT.

Description of Event or Problem · 0

N/A.

Description of Event or Problem · 0

N/A

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, HEMOPRO POWER CORD DENMARK WAS NOT BURNING/COAGULATING WHEN FUNCTION WERE ACTIVATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
110780 VASOVIEW HEMOPRO 2 ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI MAQUET CARDIOVASCULAR LLC VH-4000 25159961 00607567700864

Patients

Seq Age Sex Outcome Treatment
1 Unknown UNKNOWN.