FDA Adverse Event Summary report: N

TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM

MDR report key: 2222663 · Received July 7, 2011

Report

Report Number
1124841-2011-00305
Date Received
July 7, 2011
Date of Event
June 20, 2011
Report Date
June 21, 2011
Manufacturer
TERUMO CARDIOVASCULAR SYSTEMS CORPORATION
Product Code
GCJ
PMA / PMN Number
K031891
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Location
LA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TERUMO HAS NOT RECEIVED THE ACTUAL DEVICE FOR INVESTIGATION. TERUMO PLANS ON SUBMITTING A FOLLOW-UP REPORT WHEN THE INVESTIGATION IS COMPLETED AND MORE INFO BECOMES AVAILABLE. (B)(4).

Description of Event or Problem · 1

THE USER FACILITY REPORTED TO TERUMO CARDIOVASCULAR SYSTEMS THAT DURING VEIN HARVESTING PROCEDURE, THE ENDOSCOPE WAS BLURRY. THE PRODUCT WAS CHANGED OUT. THERE WAS NO HARM TO PT. THE SURGERY WAS COMPLETED SUCCESSFULLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TERUMO VIRTUOSAPH VEIN HARVESTING SYSTEM ENDOSCOPE GCJ TERUMO CARDIOVASCULAR SYSTEMS CORPORATION MCENDO550R NA

Patients

Seq Age Sex Outcome Treatment
1 UNK