FDA Adverse Event Summary report: N

TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM

MDR report key: 2222641 · Received July 18, 2011

Report

Report Number
1124841-2011-00317
Date Received
July 18, 2011
Date of Event
June 28, 2011
Report Date
June 28, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORP.
Product Code
GCJ
PMA / PMN Number
K083194
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

TERUMO HAS RECEIVED THE ACTUAL DEVICE FOR INVESTIGATION; HOWEVER, TERUMO IS STILL INVESTIGATING THIS ISSUE, AND TERUMO PLANS ON SUBMITTING A FOLLOW-UP REPORT WHEN THE INVESTIGATION IS COMPLETED AND MORE INFORMATION BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

THE USER FACILITY REPORTED TO TERUMO CARDIOVASCULAR SYSTEMS, THAT DURING VEIN HARVESTING, THE SWITCH THAT CONTROLS THE VEIN-KEEPER WOULD NOT SLIDE, AND THE GATE WAS LOCKED IN THE OPEN POSITION. THE PRODUCT WAS CHANGED OUT. THE SURGERY WAS COMPLETED SUCCESSFULLY. THERE WAS NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM HARVESTER GCJ TERUMO CARDIOVASCULAR SYSTEMS CORP. MCVS550 UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK