FDA Adverse Event Malfunction Summary report: N

HEMOPRO2 EXTENSION CABLE

MDR report key: 3902614 · Received May 9, 2014

Report

Report Number
2242352-2014-00537
Event Type
Malfunction
Date Received
May 9, 2014
Date of Event
April 14, 2014
Report Date
April 14, 2014
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K101274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT YET BEEN RETURNED TO MAQUET CARDIAC SURGERY FOR EVAL. WE ARE FOLLOWING UP WITH THE CUSTOMER FOR THE RETURN OF THE DEVICE. A SUPPLEMENTAL REPORT WILL BE SUBMITTED IF THE DEVICE IS RECEIVED. SINCE THIS IS AN OEM SUPPLIED DEVICE, A LOT HISTORY REVIEW IS NOT APPLICABLE. (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT THE HEMOPRO WAS NOT GETTING ADEQUATE POWER. THEY SWITCHED OUT THE CORD AND THE DEVICE WORKED FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
282247 HEMOPRO2 EXTENSION CABLE ENDOSCOPIC VESSEL HARVESTING GEI MAQUET CARDIOVASCULAR, LLC VH-4030

Patients

Seq Age Sex Outcome Treatment
1