FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO 2

MDR report key: 2201725 · Received August 4, 2011

Report

Report Number
2242352-2011-01146
Event Type
Malfunction
Date Received
August 4, 2011
Date of Event
July 29, 2011
Report Date
August 1, 2011
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K101274
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT YET BEEN RETURNED TO MAQUET CARDIAC SURGERY FOR INVESTIGATION. WE WILL CONTINUE PURSUING THE DEVICE BEING RETURNED BY THE CUSTOMER. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED. A LOT HISTORY RECORD REVIEW WAS COMPLETED FOR THE REPORTED PRODUCT LOT NUMBER. THERE WERE NO NON CONFORMANCE ISSUE(S) WITH THIS PRODUCTION LOT. INTERNAL FILE NUMBER - (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE HEMOPRO 2 STOPPED WORKING. REPORTER STATED " HE THOUGHT MAYBE IT WAS THE SAFETY SHUTDOWN AND HE WAITED THE RECOMMENDED 30 SECONDS (TIMED BY THE CLOCK). IT DID NOT RESTART AND HE COULD NOT GET IT RESTARTED AFTER SEVERAL WAITING PERIODS AND ATTEMPTS. A REPLACEMENT UNIT WAS USED TO COMPLETE THE PROCEDURE. THE HOSPITAL DID NOT REPORT ANY PT EFFECTS. MAQUET CARDIOVASCULAR ANTICIPATES RETURN OF THE PRODUCT IN QUESTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VASOVIEW HEMOPRO 2 ENDOSCOPIC VESSEL HARVESTING SYSTEM GEI MAQUET CARDIOVASCULAR, LLC VH-4000 25038756

Patients

Seq Age Sex Outcome Treatment
1 NA