FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO

MDR report key: 2240919 · Received August 17, 2011

Report

Report Number
2242352-2011-01220
Event Type
Malfunction
Date Received
August 17, 2011
Date of Event
August 15, 2011
Report Date
August 15, 2011
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K052274
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, 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 ISSUES (S) WITH THIS PRODUCTION LOT. (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE HEMOPRO REMAINED ACTIVATED MIDWAY THRU THE CASE. HARVESTER NOTICED PERSISTENT SMOKE, PULLED IT OUT AND COULD NOT SHUT IT OFF. 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 ENDOSCOPIC VESSEL HARVESTING SYSTEM GEI MAQUET CARDIOVASCULAR, LLC VH-3000 25036289

Patients

Seq Age Sex Outcome Treatment
1 NA