FDA Adverse Event Malfunction Summary report: N

VASO VIEW HEMOPRO

MDR report key: 4173338 · Received October 10, 2014

Report

Report Number
2242352-2014-01090
Event Type
Malfunction
Date Received
October 10, 2014
Date of Event
September 16, 2014
Report Date
September 16, 2014
Manufacturer
MAQUET CARDIOVASCULAR, LLC
Product Code
GEI
PMA / PMN Number
K052274
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

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 EVALUATION IS COMPLETED. A LOT HISTORY RECORD REVIEW WAS COMPLETED FOR THE REPORTED PRODUCT LOT NUMBER. THERE WAS NO NONCONFORMANCE RECORDED IN THE LOT HISTORY. THERE ARE NO OTHER SIMILAR COMPLAINTS REPORTED AGAINST THIS BATCH. (B)(4).

Description of Event or Problem · 1

THE HOSPITAL REPORTED THAT AT THE END OF AN ENDOSCOPIC VEIN HARVESTING PROCEDURE, THE HARVESTER TOOK OUT THE VASO VIEW HEMOPRO AND IT WOULD NOT SHUT OFF. THE DEVICE WAS VERY HOT AND SMOKY. THE SAME DEVICE WAS USED TO COMPLETE THE PROCEDURE. THE HOSPITAL DID NOT REPORT ANY PT EFFECTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
643023 VASO VIEW HEMOPRO ENDOSCOPIC VESSEL HARVESTING GEI MAQUET CARDIOVASCULAR, LLC VH-3000 25100686

Patients

Seq Age Sex Outcome Treatment
1