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