HEARTMATE 3 LEFT VENTRICULAR ASSIST SYSTEM 106523

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,study report with the FDA on 2020-03-31 for HEARTMATE 3 LEFT VENTRICULAR ASSIST SYSTEM 106523 manufactured by Thoratec Corporation.

Event Text Entries

[186723959] The heartmate 3 left ventricular assist system (lvas) was implanted during the momentum 3 clinical trial, ide# (b)(4). Fda approval for heartmate 3 lvas was received on 23aug2017. The gtin unique device identifier for the commercial heartmate 3 lvas is (b)(4). 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


[186723960] The patient was admitted due to worsening driveline infection. No further infection was reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2916596-2020-01789
MDR Report Key9903720
Report SourceHEALTH PROFESSIONAL,STUDY
Date Received2020-03-31
Date of Report2020-03-31
Date of Event2019-04-16
Date Mfgr Received2020-03-18
Date Added to Maude2020-03-31
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 3 LEFT VENTRICULAR ASSIST SYSTEM
Generic NameVENTRICULAR (ASSISST) BYPASS
Product CodeDSQ
Date Received2020-03-31
Model Number106523
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
101. Hospitalization 2020-03-31

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