FDA Adverse Event
Malfunction
Summary report: N
VASOVIEW HEMOPRO 2
MDR report key: 4102536
·
Received August 27, 2014
Report
- Report Number
- 2242352-2014-00933
- Event Type
- Malfunction
- Date Received
- August 27, 2014
- Date of Event
- August 1, 2014
- Report Date
- August 1, 2014
- Manufacturer
- MAQUET CARDIOVASCULAR LLC
- Product Code
- GEI
- PMA / PMN Number
- K10274
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- PHYSICIAN ASSISTANT
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE HAS BEEN RETURNED TO THE FACTORY AND IS BEING EVALUATED. A SUPPLEMENTAL REPORT WILL BE SUBMITTED WHEN THE EVAL IS COMPLETED. A LOT HISTORY RECORD WAS COMPLETED FOR THE REPORTED PRODUCT LOT NUMBER. THERE WAS NO NONCONFORMITY RECORDED IN THE LOT HISTORY. THERE ARE NO OTHER SIMILAR COMPLAINTS REPORTED AGAINST THIS BATCH. (B)(4).
Description of Event or Problem · 1
THE HOSP REPORTED THAT DURING AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE VASOVIEW HEMOPRO 2 STOPPED WORKING. IT DID NOT EMIT ENERGY. NO POWER. THEY TRIED SWITCHING OUT THE POWER CORD AND IT STILL WOULD NOT WORK. A REPLACEMENT DEVICE WAS USED TO COMPLETE THE CASE. THE HOSP DID NOT REPORT ANY PT EFFECTS.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 519091 | VASOVIEW HEMOPRO 2 | ENDOSCOPIC VESSEL HARVESTING | GEI | MAQUET CARDIOVASCULAR LLC | VH-4000 | 25098828 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 41 YR |