HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE 102953

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-02-27 for HEARTMATE II LEFT VENTRICULAR ASSIST DEVICE 102953 manufactured by Thoratec Corporation.

Event Text Entries

[183374338] No further information was provided. A supplemental report will be submitted when the manufacturer? S investigation is completed.
Patient Sequence No: 1, Text Type: N, H10


[183374339] The patient was implanted with heartmate ii lvad on (b)(6) 2011. Due to a declining right ventricle function, the patient received an rvad implant on (b)(6) 2011 for right heart support. On (b)(6) 2011, the rvad was explanted due to recovery. No further information was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2916596-2020-01058
MDR Report Key9766032
Report SourceHEALTH PROFESSIONAL
Date Received2020-02-27
Date of Report2020-02-27
Date of Event2011-10-15
Date Mfgr Received2020-02-12
Date Added to Maude2020-02-27
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. BOB FRYC
Manufacturer Street6035 STONERIDGE DRIVE
Manufacturer CityPLEASANTON CA 94588
Manufacturer CountryUS
Manufacturer Postal94588
Manufacturer Phone7818528204
Manufacturer G1THORATEC CORPORATION
Manufacturer Street6035 STONERIDGE DRIVE
Manufacturer CityPLEASANTON CA 95488
Manufacturer CountryUS
Manufacturer Postal Code95488
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameHEARTMATE II LEFT VENTRICULAR ASSIST DEVICE
Generic NamePUMP, BLOOD, CARDIOPULMONARY BYPASS, NON-ROLLER TYPE
Product CodeKFM
Date Received2020-02-27
Model Number102953
Catalog Number102953
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerTHORATEC CORPORATION
Manufacturer Address6035 STONERIDGE DRIVE PLEASANTON CA 95488 US 95488


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-27

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