FDA Adverse Event
Injury
Summary report: N
HEARTMATE II LVAS
MDR report key: 3093844
·
Received April 30, 2013
Report
- Report Number
- 2916596-2013-00519
- Event Type
- Injury
- Date Received
- April 30, 2013
- Date of Event
- March 25, 2013
- Report Date
- April 5, 2013
- Manufacturer
- THORATEC CORP.
- Product Code
- DSQ
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, US
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
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 PATIENT WAS IMPLANTED WITH A LEFT VENTRICULAR ASSIST DEVICE (LVAD). THE VAD COORDINATOR REPORTED THAT THE PATIENT IS EXPERIENCING ISSUES WITH HEMOLYSIS. FIBRINOGEN LEVELS HAVE INCREASED AND THE HOSPITAL BELIEVES THE PATIENT HAS A COAGULATION ISSUE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 187673 | HEARTMATE II LVAS | DSQ: LEFT VENTRICULAR ASSIST DEVICE | DSQ | THORATEC CORP. | 104911 | 124867 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 57 YR | Other |