| Brand Name | Thoratec® HeartMate 3® LVAS Implant Kit |
| Common Device Name | Ventricular (Assist) Bypass |
| Manufacturer (Section D) |
| Thoratec Corporation |
| 6035 stoneridge drive |
| pleasanton CA 94588 |
|
| Manufacturer (Section G) |
| Thoratec Corporation |
| 6035 stoneridge drive |
|
| pleasanton CA 94588 |
|
| Manufacturer Contact |
|
fredric
gold
|
| 6035 stoneridge drive |
| pleasanton, CA 94588
|
|
+1(781)852-8207
|
|
| MDR Report Key | 50935955 |
| Report Number | 2916596-2026-2919777 |
| Device Sequence Number | 9689107 |
| Product Code |
DSQ
|
| UDI-Device Identifier | 05415067039323 |
| Combination Product (Y/N) | N |
| Initial Reporter State | FL |
| Initial Reporter Country | US |
| PMA/510(K) Number | P160054 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Device Implanted Year | 2026 |
| Serviced by Third Party (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,Company Representative |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
09/29/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
Yes
|
| Is this a Product Problem Report? |
No
|
| Operator of Device |
Lay User/Patient
|
| Device Model Number | 106524US |
| Device Catalogue Number | 106524US |
| Device Lot Number | L00006838 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 09/02/2026 |
| Initial Report FDA Received Date | 09/29/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 05/21/2026 |
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Initial
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Life Threatening;
|
| Patient Age | 21 YR |
| Patient Sex | Female |
| Patient Weight | 224 LB |
| Patient Race | Black Or African American |