FDA Adverse Event
Injury
Summary report: N
HEARTMATE II LVAS
MDR report key: 2020745
·
Received March 16, 2011
Report
- Report Number
- 2020745
- Event Type
- Injury
- Date Received
- March 16, 2011
- Date of Event
- May 11, 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: EXTERNAL CONTROL SYSTEM FAILURE. ADDITIONAL TEXT: UNEXPLAINED/INTERMITTENT ALARMS. SPECIFIC COMPONENT(S) INVOLVED: OTHER COMPONENT MALFUNCTION, SPECIFY. ADDITIONAL TEXT: OTHER COMPONENT: UNEXPLAINED/INTERMITTENT ALARMS. CAUSATIVE OR CONTRIBUTING FACTOR: NO SPECIFIC CONTRIBUTING CAUSE IDENTIFIED. OTHER CAUSE: INTERVENTION(S): OTHER INTERVENTIONS, SPECIFY. OTHER INTERVENTION : REPLACED PM PATIENT CABLE. IMPLANT DEVICE TYPE: LVAD.
Description of Event or Problem · 1
MAJOR PUMP UNIT(S) INVOLVED: EXTERNAL CONTROL SYSTEM FAILURESPECIFIC COMPONENT(S) INVOLVED: OTHER COMPONENT MALFUNCTION, SPECIFY
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 | 43.7 YR |