FDA Adverse Event
Injury
Summary report: N
HEARTMATE II LVAD
MDR report key: 3111339
·
Received May 9, 2013
Report
- Report Number
- 2916596-2013-00539
- Event Type
- Injury
- Date Received
- May 9, 2013
- Date of Event
- April 12, 2013
- Report Date
- April 12, 2013
- Manufacturer
- THORATEC CORP.
- Product Code
- DSQ
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WI, US
- Reporter Occupation
- HEALTH PROFESSIONAL
Narratives
Additional Manufacturer Narrative · 1
THE PATIENT REMAINS ONGOING WITH THE IMPLANTED DEVICE AND NO FURTHER ISSUES HAVE BEEN REPORTED. NO FURTHER INFORMATION IS AVAILABLE AT THIS TIME. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE MANUFACTURER'S INVESTIGATION IS COMPLETED.
Description of Event or Problem · 1
THE PATIENT WAS IMPLANTED WITH A LEFT VENTRICULAR ASSIST DEVICE (LVAD). IT WAS REPORTED BY THE VAD COORDINATOR THAT THE PATIENT HAD AN EPISODE OF EPISTAXIS. HEMOGLOBIN AND HEMATOCRIT VALUES NOTED TO BE REDUCED BY 2 GRAMS. NO OTHER SOURCES OF BLEED FOUND. COUMADIN HELD AND RESTARTED WITH LOWER INTERNATIONAL NORMALIZED RATIO (INR) GOAL OF 1.5-2.0. PATIENT WAS DISCHARGED AND NO FURTHER ISSUES HAVE BEEN REPORTED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 204689 | HEARTMATE II LVAD | DSQ: LEFT VENTRICULAR ASSIST DEVICE | DSQ | THORATEC CORP. | 104911 | 116893 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 63 YR | Required Intervention |