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