FDA Adverse Event Summary report: N

TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM

MDR report key: 2032737 · Received March 23, 2011

Report

Report Number
1124841-2011-00160
Date Received
March 23, 2011
Date of Event
March 3, 2011
Report Date
March 4, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORPORATION
Product Code
GCJ
PMA / PMN Number
K031891
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, 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. (B)(4).

Description of Event or Problem · 1

THE USER FACILITY REPORTED TO TERUMO CARDIOVASCULAR SYSTEMS THAT AFTER VEIN HARVESTING PROCEDURE, THE ENDOSCOPE WAS BLURRY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM ENDOSCOPE GCJ TERUMO CARDIOVASCULAR SYSTEMS CORPORATION MCENDO550 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK