FDA Adverse Event Death Summary report: N

HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE

MDR report key: 2431793 · Received January 24, 2012

Report

Report Number
2916596-2012-00014
Event Type
Death
Date Received
January 24, 2012
Date of Event
December 20, 2011
Report Date
December 28, 2011
Manufacturer
THORATEC CORP.
Product Code
DSQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE MFR IS ATTEMPTING TO ACQUIRE THE DEVICE FOR FURTHER EVAL. NO FURTHER INFO IS AVAILABLE AT THIS TIME. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE MFR'S INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

THE PT WAS IMPLANTED WITH A LEFT VENTRICULAR ASSIST DEVICE. THE PERFUSIONIST REPORTED THAT THE PT EXPERIENCED A HEMORRHAGIC STROKE AND RESPIRATORY COMPROMISE. LIFE SUPPORT WAS WITHDRAWN AT THE FAMILY'S REQUEST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE LEFT VENTRICULAR ASSIST DEVICE DSQ THORATEC CORP. 104911 107661

Patients

Seq Age Sex Outcome Treatment
1 76 YR Death