BEUDAMED
    FDA Adverse Event Other Summary report: N

    HEARTWARE

    MDR report key: 3342045 · Received September 6, 2013

    Report

    Report Number
    MW5031753
    Event Type
    Other
    Date Received
    September 6, 2013
    Date of Event
    July 13, 2013
    Report Date
    September 5, 2013
    Manufacturer
    HEARTWARE
    Product Code
    DSQ
    Report Source
    Voluntary report
    Reporter Location
    PA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    PT CHANGING LVAD POWER SOURCE AND BOTH POWER SOURCES SIMULTANEOUSLY DISCONNECTED. NURSE INTERVENED. OUR CONCERN WAS THAT IT WAS POSSIBLE TO DISCONNECT BOTH POWER SOURCES SIMULTANEOUSLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    444575 HEARTWARE LEFT VENTRICULAR ASSIST DEVICE DSQ HEARTWARE

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Other