FDA Adverse Event Summary report: N

VASOVIEW 6 EVH SYSTEM

MDR report key: 2222779 · Received August 10, 2011

Report

Report Number
2242352-2011-01099
Date Received
August 10, 2011
Report Date
July 26, 2011
Manufacturer
MAQUET CARDIOVASCULAR, LLC.
Product Code
GEI
PMA / PMN Number
K041981
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WV, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS CURRENTLY BEING INVESTIGATED AND THE RESULTS ARE BEING EVALUATED AND ANALYZED WITH SIMILAR EVENTS. A F/U REPORT WILL BE SUBMITTED ONCE THE DEVICE EVAL IS COMPLETE. ITEMS MARKED "NI" ARE UNK TO US AT THIS TIME. INTERNAL FILE NUMBER - (B)(4).

Description of Event or Problem · 1

THE HOSP REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE VASOVIEW 6 WOULD NOT WORK. A REPLACEMENT UNIT WAS USED TO COMPLETE THE PROCEDURE. THE HOSP DID NOT REPORT ANY PT EFFECTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VASOVIEW 6 EVH SYSTEM ENDOSCOPIC VESSEL HARVESTING SYSTEM GEI MAQUET CARDIOVASCULAR, LLC. VH-2000 0300001309

Patients

Seq Age Sex Outcome Treatment
1 NI