BEUDAMED
    FDA Adverse Event Death Summary report: N

    HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE

    MDR report key: 3233663 · Received July 16, 2013

    Report

    Report Number
    2916596-2013-00864
    Event Type
    Death
    Date Received
    July 16, 2013
    Date of Event
    June 25, 2013
    Report Date
    June 25, 2013
    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 PATIENT EXPIRED. 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. THE VAD COORDINATOR REPORTED THAT THE PATIENT'S PUMP STOPPED AND THE PATIENT ARRESTED TWICE. THE PATIENT HAD PREVIOUS EVENTS OF TRANSIENT ISCHEMIC ATTACK. THE PATIENT EXPIRED OF ANOXIC BRAIN INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    330399 HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE DSQ: LEFT BENTRICULAR ASSIST DEVICE DSQ THORATEC CORP. 104911 119467

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Death