FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO 2

MDR report key: 20568330 · Received October 30, 2024

Report

Report Number
2242352-2024-0001196
Event Type
Malfunction
Date Received
October 30, 2024
Date of Event
October 10, 2024
Report Date
November 20, 2024
Manufacturer
MAQUET CARDIOVASCULAR LLC
Product Code
GEI
UDI-DI
00607567700406
PMA / PMN Number
K101274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

TW ID# (B)(4) THE DEVICE HAS BEEN RETURNED TO THE FACTORY AND IS BEING EVALUATED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE EVALUATION IS COMPLETED.

Additional Manufacturer Narrative · 0

TRACKWISE#: (B)(4). UPDATED SECTIONS: B4, G3, G6, H2, H3, H6, H11. CORRECTED SECTIONS: H6--MEDICAL DEVICE ¿ PROBLEM CODE CORRECTED FROM "2183" TO "2900 AND 2954" THE DEVICE WAS RETURNED TO THE FACTORY FOR EVALUATION ON 10/16/2024. AN INVESTIGATION WAS CONDUCTED ON 11/05/2024. A VISUAL INSPECTION WAS CONDUCTED. SIGNS OF CLINICAL USE AND EVIDENCE OF BLOOD WAS OBSERVED. THERE WERE NO VISUAL DEFECTS OBSERVED ON THE INTACT BTT. THE BTT WAS ABLE TO BE INFLATED. NO VISUAL DEFECTS WERE OBSERVED ON THE SILICONE BTT. A 5CC SYRINGE FILLED WITH SALINE WAS ATTACHED TO THE CO2 LINE ON THE BTT WITH NO PHYSICAL OR VISUAL DIFFICULTIES OBSERVED AND SQUEEZED THE SYRINGE TO SPRAY THE SALINE. THERE WAS NO BACKFLOW OBSERVED IN THE CO2 LINE. BASED ON THE RETURNED CONDITION OF THE DEVICE AS WELL AS THE EVALUATION RESULTS, THE REPORTED FAILURES "CONNECTION PROBLEM" AND "IMPROPER FLOW OR INFUSION" WERE NOT CONFIRMED. THE LOT # 3000422800 HISTORY RECORD REVIEW WAS COMPLETED. THERE WERE NO NCMRS, REWORK, OR DEVIATIONS DOCUMENTED FOR THE REPORTED LOT NUMBER. BASED ON THE DHR/LHR REVIEW RESULTS, IT WAS DETERMINED THAT THERE IS NO RELATION BETWEEN THE BATCH MANUFACTURING PROCESS AND THE REPORTED FAILURES.

Description of Event or Problem · 0

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, VASOVIEW HEMOPRO 2 WAS HAVING ISSUES WITH INSUFFLATION INTO THE TUNNEL. THE INSUFFLATION TUBING'S MALE END WAS NOT PUSHING THE BTT FEMALE VALVE DOWN. SO INSUFFLATION WAS NOT GETTING INTO THE TUNNEL CORRECTLY. THEY STRUGGLED AND WERE ABLE TO GET THE VEIN OUT WITH NO ISSUES TO PATIENT OR THE VEIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1020574 VASOVIEW HEMOPRO 2 ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI MAQUET CARDIOVASCULAR LLC VH-4000 3000422800 00607567700406

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown UNKNOWN.