FDA Adverse Event Summary report: N

TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM

MDR report key: 2001858 · Received February 21, 2011

Report

Report Number
1124841-2011-00050
Date Received
February 21, 2011
Date of Event
February 1, 2011
Report Date
February 1, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
GCJ
PMA / PMN Number
K031891
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

TERUMO HAS NOT RECEIVED THE ACTUAL DEVICE FOR INVESTIGATION. TERUMO PLANS ON SUBMITTING A F/U REPORT WHEN THE INVESTIGATION IS COMPLETED AND MORE INFO BECOMES AVAILABLE. FOR THIS REASON, TERUMO REFERENCES EVAL CODES. (B)(4).

Description of Event or Problem · 1

THE USER FACILITY REPORTED TO TERUMO CARDIOVASCULAR SYSTEMS THAT DURING CLEANING THEY DISCOVERED THE ENDOSCOPE WAS BLURRY. THERE WAS NO PT INVOLVEMENT AS THIS OCCURRED DURING CLEANING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM ENDOSCOPE GCJ TERUMO CARDIOVASCULAR SYSTEMS CORP. MCENDO550R NA

Patients

Seq Age Sex Outcome Treatment
1 UNK