FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO EVH SYSTEM

MDR report key: 2152364 · Received June 24, 2011

Report

Report Number
2242352-2011-00692
Event Type
Malfunction
Date Received
June 24, 2011
Report Date
June 1, 2011
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K052274
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

METHOD: THE DEVICE WILL REPORTEDLY NOT BE RETURNED TO MAQUET CARDIAC SURGERY FOR INVESTIGATION. THE LOT NUMBER COULD NOT BE OBTAINED SO A LOT HISTORY RECORD REVIEW COULD NOT BE PERFORMED. INTERNAL FILE NUMBER - (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VESSEL HARVESTING PROCEDURE, THE VASOVIEW HEMOPRO DEVICE STAYED "ON" WHEN THE BUTTON WAS IN THE OFF POSITION. THIS OCCURRED OUTSIDE OF THE PATIENT, BUT NOT DURING THE PRE-TEST. A NEW KIT AND CORD WERE USED TO COMPLETE THE PROCEDURE. THERE WERE NO PATIENT EFFECTS. THE PRODUCT IS NOT RETURNING.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 NA