BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HEARTMATE II LVAS

    MDR report key: 2020741 · Received March 16, 2011

    Report

    Report Number
    2020741
    Event Type
    Injury
    Date Received
    March 16, 2011
    Date of Event
    March 2, 2010
    Report Date
    May 31, 2011
    Manufacturer
    THORATEC CORPORATION
    Product Code
    DSQ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    AL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    MAJOR PUMP UNIT(S) INVOLVED: BLOOD PUMPSPECIFIC COMPONENT(S) INVOLVED: OUTFLOW GRAFT MALFUNCTION/MALPOSITION

    Description of Event or Problem · 1

    MAJOR PUMP UNIT(S) INVOLVED: BLOOD PUMP. ADDITIONAL TEXT: OUTFLOW GRAFT MALFUNCTION. SPECIFIC COMPONENT(S) INVOLVED: OUTFLOW GRAFT MALFUNCTION/MALPOSITION. ADDITIONAL TEXT: LEAD Y-UNABLE TO PRE-CLOT. OTHER COMPONENT: CAUSATIVE OR CONTRIBUTING FACTOR: NO SPECIFIC CONTRIBUTING CAUSE IDENTIFIED. OTHER CAUSE: INTERVENTION(S): REPLACEMENT OF OUTFLOW GRAFT. OTHER INTERVENTION : IMPLANT DEVICE TYPE: LVAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEARTMATE II LVAS LVAD DSQ THORATEC CORPORATION

    Patients

    Seq Age Sex Outcome Treatment
    1 60.1 YR