BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    VASOVIEW HEMOPRO 2

    MDR report key: 16529967 · Received March 13, 2023

    Report

    Report Number
    2242352-2023-00194
    Event Type
    Malfunction
    Date Received
    March 13, 2023
    Date of Event
    February 13, 2023
    Report Date
    July 18, 2023
    Manufacturer
    MAQUET CARDIOVASCULAR LLC
    Product Code
    GEI
    UDI-DI
    00607567700406
    PMA / PMN Number
    K101274
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL
    Health Professional
    Yes

    Narratives

    Additional Manufacturer Narrative · 0

    TRACKWISE # (B)(4). THE LOT # 3000288362 HISTORY RECORD REVIEW WAS COMPLETED. 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 BATCH MANUFACTURING PROCESS AND THE REPORTED FAILURE. H3 OTHER TEXT : DEVICE DISCARDED.

    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

    RELATED TO 770100, 771461, 771559 AND 771620.

    Description of Event or Problem · 0

    RELATED TO (B)(4). THE HOSPITAL REPORTED THAT THE HEMOPRO 2 LOT # 300288362 FELL APART AND REFUSE TO USE THE REMAINING DEVICE LEFT ON THE SHELF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    678804 VASOVIEW HEMOPRO 2 ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI MAQUET CARDIOVASCULAR LLC VH-4000 3000288362 00607567700406

    Patients

    Seq Age Sex Outcome Treatment
    1 Unknown N/A.| UNK.