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