FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO 2

MDR report key: 2240930 · Received August 17, 2011

Report

Report Number
2242352-2011-01217
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
K101274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, 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. (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE HEMOPRO 2 HEATER WIRE PARTIALLY DISLODGED FROM THE JAWS. THE REPORTER STATED "RIGHT WHEN STARTING LIGATION, AFTER ONLY 2 OR 3 BURNS, COULD SEE INTO THE TUNNEL AND SAW A PIECE OF METAL ON THE JAWS. THE PRODUCT WAS PULLED OUT OF THE TUNNEL AND WHEN THE JAWS WERE OPENED, THE WIRING INSIDE THE JAWS (THAT CONDUCTS THE HEAT) HAD PARTIALLY PULLED AWAY". A REPLACEMENT UNIT WAS USED TO COMPLETE THE PROCEDURE. THE HOSPITAL DID NOT REPORT ANY PATIENT 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 25037668

Patients

Seq Age Sex Outcome Treatment
1 NA