FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO

MDR report key: 16938978 · Received May 16, 2023

Report

Report Number
2242352-2023-00388
Event Type
Malfunction
Date Received
May 16, 2023
Date of Event
April 21, 2023
Report Date
October 18, 2023
Manufacturer
MAQUET CARDIOVASCULAR LLC
Product Code
GEI
UDI-DI
00607567701250
PMA / PMN Number
K153194
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AZ
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

TRACKWISE#: (B)(4). THE DEVICE WAS RETURNED TO THE FACTORY FOR EVALUATION ON 05/02/2023. AN INVESTIGATION WAS CONDUCTED ON 05/10/2023. A VISUAL INSPECTION WAS CONDUCTED. SIGNS OF CLINICAL USE AND EVIDENCE OF BLOOD WAS OBSERVED. THE CANNULA WAS NOT RETURNED FOR EVALUATION, HOWEVER THE BTT WAS RETURNED. THERE WERE NO VISUAL DEFECTS OBSERVED ON THE INTACT BTT. THE BTT WAS ABLE TO BE INFLATED. THE INSUFFLATION PORT WAS OBSERVED TO BE DETACHED FROM THE BTT. THE DETACHED PORT WAS NOT RETURNED FOR EVALUATION. BASED ON THE RETURNED CONDITION OF THE DEVICE AS WELL AS THE EVALUATION RESULTS, THE REPORTED FAILURE "BREAK; CANNULA; TUBE" WAS NOT CONFIRMED, HOWEVER, THE ANALYZED FAILURE "BREAK; BTT" WAS OBSERVED. AN ENGINEER EVALUATION WAS CONDUCTED. AFTER INSPECTION OF THE DEVICE, IT WAS IDENTIFIED THAT THERE WAS VISIBLY EITHER VERY LITTLE OR NO ADHESIVE ON THE INSUFFLATION TUBING/BTT PORT. BASED ON THE RETURNED CONDITION OF THE DEVICE AS WELL AS THE EVALUATION RESULTS, THE REPORTED FAILURE "BREAK; CANNULA; TUBE" WAS NOT CONFIRMED, HOWEVER, THE ANALYZED FAILURE "BREAK; BTT" WAS OBSERVED. THE DHR, SHOP FLOOR PAPERWORK WAS REVIEWED. THE VENDOR CERTIFIES THAT THIS DEVICE LOT CONFORMS TO ALL APPLICABLE PRODUCT SPECIFICATIONS. SPECIFIC ACTIONS FOR THE REPORTED FAILURE MODE ARE BEING MAINTAINED AND DOCUMENTED UNDER MAQUET'S CORRECTIVE AND PREVENTIVE ACTION (CAPA) SYSTEM.

Additional Manufacturer Narrative · 0

TRACKWISE#:(B)(4). THE DEVICE WAS RETURNED TO THE FACTORY FOR EVALUATION ON 05/02/2023. AN INVESTIGATION WAS CONDUCTED ON 05/10/2023. A VISUAL INSPECTION WAS CONDUCTED. SIGNS OF CLINICAL USE AND EVIDENCE OF BLOOD WAS OBSERVED. THE CANNULA WAS NOT RETURNED FOR EVALUATION, HOWEVER THE BTT WAS RETURNED. THERE WERE NO VISUAL DEFECTS OBSERVED ON THE INTACT BTT. THE BTT WAS ABLE TO BE INFLATED. THE INSUFFLATION PORT WAS OBSERVED TO BE DETACHED FROM THE BTT. THE DETACHED PORT WAS NOT RETURNED FOR EVALUATION. BASED ON THE RETURNED CONDITION OF THE DEVICE AS WELL AS THE EVALUATION RESULTS, THE REPORTED FAILURE "BREAK; CANNULA; TUBE" WAS NOT CONFIRMED, HOWEVER, THE ANALYZED FAILURE "BREAK; BTT" WAS OBSERVED. THE DHR, SHOP FLOOR PAPERWORK WAS REVIEWED. THE VENDOR CERTIFIES THAT THIS DEVICE SERIAL/LOT CONFORMS TO ALL APPLICABLE PRODUCT SPECIFICATIONS. THE LOT # 3000293522 HISTORY RECORD REVIEW WAS COMPLETED. BASED ON THE DHR/LHR REVIEW RESULTS, IT WAS DETERMINED THAT THERE IS NO RELATION BETWEEN THE BATCH MANUFACTURING PROCESS AND THE REPORTED FAILURE.

Additional Manufacturer Narrative · 0

TRACKWISE ID (B)(6). THE DEVICE HAS BEEN RETURNED TO THE FACTORY AND IS BEING EVALUATED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETED.

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 BEFORE THE PATIENT WAS IN THE ROOM FOR THE ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE VASOVIEW HEMOPRO (US) VH-3500 TUBING FROM THE CANNULA BROKE OFF BEFORE IT COULD BE USED. THERE WAS A SLIGHT DELAY TO THE HARVESTING BUT NOT THE HEART SURGERY. ANOTHER DEVICE WAS OPENED AND USED. NO PATIENT HARM REPORTED, AS THERE WAS NO PATIENT INVOLVEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1637928 VASOVIEW HEMOPRO ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI MAQUET CARDIOVASCULAR LLC VH-3500 3000293522 00607567701250

Patients

Seq Age Sex Outcome Treatment
1 Prefer Not To Disclose N/A.