FDA Adverse Event
Injury
Summary report: N
HEARTMATE II LVAS
MDR report key: 2190856
·
Received July 27, 2011
Report
- Report Number
- 2916596-2011-00312
- Event Type
- Injury
- Date Received
- July 27, 2011
- Date of Event
- July 5, 2011
- Report Date
- July 6, 2011
- Manufacturer
- THORATEC CORP
- Product Code
- DSQ
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NC, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE EXPLANTED DEVICE WAS RETURNED TO THE MANUFACTURER FOR EVAL AND IS CURRENTLY BEING ANALYZED. NO FURTHER INFO IS AVAILABLE AT THIS TIME. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE DEVICE ANALYSIS IS COMPLETED.
Description of Event or Problem · 1
THE PT WAS IMPLANTED WITH A LEFT VENTRICULAR ASSIST DEVICE (LVAD). THE VAD COORDINATOR REPORTED THAT THE HOSPITAL MADE A DECISION TO EXCHANGE THE LVAD DUE TO THE PT PRESENTING WITH A "METHICILLIN-SENSITIVE S AUREUS (MSSA) BACTEREMIA INFECTION" OF UNK ORIGIN. THE DEVICE WAS SUCCESSFULLY EXCHANGED WITH ANOTHER LVAD AND THE PT REMAINS ONGOING ON LVAD SUPPORT WITHOUT ANY FURTHER ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HEARTMATE II LVAS | LEFT VENTRICULAR ASSIST DEVICE | DSQ | THORATEC CORP | 103695 | 90920 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 57 YR | Required Intervention |