FDA Adverse Event Malfunction Summary report: N

TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM

MDR report key: 1840626 · Received September 17, 2010

Report

Report Number
1828100-2010-01428
Event Type
Malfunction
Date Received
September 17, 2010
Date of Event
August 23, 2010
Report Date
September 17, 2010
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP
Product Code
GCJ
PMA / PMN Number
K031891
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
NOT APPLICABLE

Narratives

Description of Event or Problem · 1

DURING USE OF THE DEVICE FOR A NON-CLINICAL ACTIVITY, THE USER REPORTED THE ENDOSCOPE WAS CLOUDY. NO OTHER DETAILS REGARDING THE NATURE OF THE EVENT WERE PROVIDED. SINCE THIS EVENT OCCURRED DURING A NON-CLINICAL ACTIVITY, THERE WAS NO PT INVOLVEMENT DURING THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM ENDOSCOPE GCJ TERUMO CARDIOVASCULAR SYSTEMS CORP MCENDO550

Patients

Seq Age Sex Outcome Treatment
1