BEUDAMED
    FDA Adverse Event Injury Summary report: N

    VASOVIEW HEMOPRO

    MDR report key: 2150753 · Received June 30, 2011

    Report

    Report Number
    MW5021222
    Event Type
    Injury
    Date Received
    June 30, 2011
    Date of Event
    June 21, 2011
    Report Date
    June 23, 2011
    Manufacturer
    MAQUET CARDIOVASCULAR
    Product Code
    GEI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    FL, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    ENDOSCOPIC VEIN HARVEST-INSULATION TIP TORE FROM TIP OF DEVICE DURING PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VASOVIEW HEMOPRO ENDOSCOPIC VESSEL HARVESTING SYSTEM GEI MAQUET CARDIOVASCULAR VH-3000 25035141

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Required Intervention