FDA Adverse Event Death Summary report: N

HEARTMATE II LVAS

MDR report key: 1714602 · Received June 8, 2010

Report

Report Number
2916596-2010-00134
Event Type
Death
Date Received
June 8, 2010
Date of Event
May 9, 2010
Report Date
May 11, 2010
Manufacturer
THORATEC CORPORATION
Product Code
DSQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE MANUFACTURER IS ATTEMPTING TO ACQUIRE THE EXPLANTED DEVICE FOR FURTHER EVALUATION. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

THE PATIENT WAS IMPLANTED WITH A LEFT VENTRICULAR ASSIST DEVICE (LVAD). THE CIRCULATORY RESEARCH COORDINATOR REPORTED THAT THE PATIENT EXPIRED APPROXIMATELY TWO-AND-A-HALF WEEKS POST IMPLANTATION OF THE LVAD. THE HOSPITAL SUSPECTED THROMBUS IN THE DEVICE. THERE WERE NO ALARMS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTMATE II LVAS LEFT VENTRICULAR ASSIST DEVICE DSQ THORATEC CORPORATION 103695 89493

Patients

Seq Age Sex Outcome Treatment
1 56 YR Death