FDA Adverse Event Injury Summary report: N

HEARTMATE 3 LVAS IMPLANT KIT

MDR report key: 15931604 · Received December 7, 2022

Report

Report Number
2916596-2022-15538
Event Type
Injury
Date Received
December 7, 2022
Date of Event
August 24, 2022
Report Date
December 7, 2022
Manufacturer
THORATEC CORPORATION
Product Code
DSQ
UDI-DI
00813024013297
PMA / PMN Number
P160054
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PREVIOUS ADMISSIONS FOR INFECTION: MFR # 2916596-2022-15405. MANUFACTURER'S INVESTIGATION CONCLUSION: THE PUMP REMAINED IN USE UNTIL (B)(6) 2022 (MFR#2916596-2022-15533). A CORRELATION BETWEEN THE DEVICE AND THE REPORT OF INFECTION COULD NOT BE CONCLUSIVELY DETERMINED. INFECTION IS LISTED IN THE INSTRUCTIONS FOR USE AS A POTENTIAL ADVERSE EVENT THAT MAY BE ASSOCIATED WITH THE USE OF HEARTMATE 3 LEFT VENTRICULAR ASSIST SYSTEM. INFECTION HAS BEEN PREVIOUSLY INVESTIGATED AND WILL CONTINUE TO BE MONITORED THROUGH QUALITY DATA REVIEWS, WHICH ARE CONDUCTED ON PRODUCTION AND POST PRODUCT SIGNALS TO EVALUATE IF PRODUCTS ARE CONFORMING TO PRODUCT REQUIREMENTS. NO FURTHER INFORMATION WAS PROVIDED. THE MANUFACTURER IS CLOSING THE FILE ON THIS EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT WAS ADMITTED ON (B)(6) 2022 FOR DRIVELINE EXIT SITE REVISION CONCERNING INFECTION AND WAS DISCHARGED ON (B)(6) 2022.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2470902 HEARTMATE 3 LVAS IMPLANT KIT VENTRICULAR (ASSIST) BYPASS DSQ THORATEC CORPORATION 106524US 7172162 00813024013297

Patients

Seq Age Sex Outcome Treatment
1 74 YR Male Hospitalization| R