FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO EVH SYSTEM

MDR report key: 1994388 · Received January 14, 2011

Report

Report Number
2242352-2010-04014
Event Type
Malfunction
Date Received
January 14, 2011
Date of Event
December 16, 2010
Report Date
December 17, 2010
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K052274
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WILL REPORTEDLY NOT BE RETURNED TO MAQUET CARDIAC SURGERY FOR INVESTIGATION. A LOT HISTORY RECORD REVIEW WAS COMPLETED FOR THE PRODUCT. THERE WAS NO NONCONFORMANCE WHICH COULD HAVE CONTRIBUTED TO THIS FAILURE MODE. (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE HEMOPRO JAWS WOULD NOT CAUTERIZE. THE CABLE WAS SWITCHED BUT THE PROBLEM PERSISTED. A REPLACEMENT UNIT AND CABLE WERE USED TO COMPLETE THE PROCEDURE. THE HOSPITAL DID NOT REPORT ANY PT EFFECTS. THE PRODUCTS WERE DISCARDED. IT WAS ALSO REPORTED THAT THE HOSPITAL HAD A HARD TIME KEEPING TRACK OF HOW MAY TIMES THE CABLE WAS STERILIZED SO THEY DISCARDED THE CABLE AS WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VASOVIEW HEMOPRO EVH SYSTEM ENDOSCOPIC VESSEL HARVESTING SYSTEM GEI MAQUET CARDIOVASCULAR, LLC VH-3000 25023958

Patients

Seq Age Sex Outcome Treatment
1 NA