FDA Adverse Event
Injury
Summary report: N
HEARTMATE II LVAS
MDR report key: 2251852
·
Received September 16, 2011
Report
- Report Number
- 2251852
- Event Type
- Injury
- Date Received
- September 16, 2011
- Date of Event
- January 5, 2010
- Report Date
- October 9, 2012
- Manufacturer
- THORATEC CORPORATION
- Product Code
- DSQ
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- User Facility report
- Reporter Location
- AL, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
MAJOR PUMP UNIT(S) INVOLVED: BLOOD PUMPSPECIFIC COMPONENT(S) INVOLVED: PUMP DRIVE UNIT MALFUNCTION
Description of Event or Problem · 1
MAJOR PUMP UNIT(S) INVOLVED: BLOOD PUMP.ADDITIONAL TEXT: POWER SPIKES.SPECIFIC COMPONENT(S) INVOLVED: PUMP DRIVE UNIT MALFUNCTION.ADDITIONAL TEXT: POWER SPIKES.OTHER COMPONENT:CAUSATIVE OR CONTRIBUTING FACTOR: NO SPECIFIC CONTRIBUTING CAUSE IDENTIFIED.OTHER CAUSE:INTERVENTION(S): OTHER INTERVENTIONS, SPECIFY.OTHER INTERVENTION : ANTI-COAGULATION.IMPLANT DEVICE TYPE: LVAD.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | HEARTMATE II LVAS | LVAD | DSQ | THORATEC CORPORATION |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 65.6 YR |