FDA Adverse Event Malfunction Summary report: N

VASOVIEW HEMOPRO

MDR report key: 3772220 · Received January 2, 2014

Report

Report Number
2242352-2013-01820
Event Type
Malfunction
Date Received
January 2, 2014
Date of Event
December 6, 2013
Report Date
December 11, 2013
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K052274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT YET BEEN RETURNED TO MAQUET CARDIAC SURGERY FOR EVALUATION. WE AR FOLLOWING UP WITH THE CUSTOMER FOR THE RETURN OF THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED. A LOT HISTORY RECORD REVIEW WAS COMPLETED FOR THE REPORTED PRODUCT LOT NUMBER. THERE WAS NO NON-CONFORMANCE RECORDED IN THE LOT HISTORY. (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT DURING PREPARATION FOR AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, WHILE TESTING THE VACO VIEW HEMOPRO IT WOULD NOT TURN OFF AND REMAINED ACTIVATED WHEN THE TRIGGER WAS NOT BEING DEPRESSED. A VASOVIEW HEMOPRO 2 WAS USED TO COMPLETE THE PROCEDURE. THE HOSPITAL DID NOT REPORT ANY PATIENT EFFECTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2591 VASOVIEW HEMOPRO ENDOSCOPIC VESSEL HARVESTING GEI MAQUET CARDIOVASCULAR, LLC VH-3000 25086223

Patients

Seq Age Sex Outcome Treatment
1 NI