FDA Adverse Event Injury Summary report: N

HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE

MDR report key: 3780721 · Received April 22, 2014

Report

Report Number
2916596-2014-00633
Event Type
Injury
Date Received
April 22, 2014
Date of Event
February 26, 2014
Report Date
March 25, 2014
Manufacturer
THORATEC CORP.
Product Code
DSQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TN, 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 PT WAS IMPLANTED WITH A LEFT VENTRICULAR ASSIST DEVICE (LVAD). IT WAS REPORTED BY THE VAD COORDINATOR THAT THE PT SUFFERED AN EMBOLIC STROKE. PUMP THROMBUS WAS SUSPECTED. THE PT HAS SIGNS AND SYMPTOMS OF HEMOLYSIS WITH ELEVATED LDH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
243901 HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE DSQ: LEFT VENTRICULAR ASSIST DEVICE DSQ THORATEC CORP. 104911 124864

Patients

Seq Age Sex Outcome Treatment
1 56 YR Required Intervention