In 2014, when the Food and Drug Administration found serious problems with a life-sustaining heart pump, its warning letter to the manufacturer threatened to notify other federal health agencies about the inspection's findings. But for years, no such alert ever went out. Instead, the agency added the warning letter to an online database alongside thousands of others, following its typical procedures, an FDA spokesperson said.

Agencies such as the Centers for Medicare & Medicaid Services and the U.S. Department of Veterans Affairs went on paying to implant the HeartWare Ventricular Assist Device, or HVAD, in new patients even though federal inspectors had found problems with the device linked to patient deaths and injuries. If crucial safety information in FDA warning letters doesn't make it to other arms of the government responsible for deciding which medical devices to pay for, experts said patients are the ones put at risk.

The FDA acknowledged that it doesn't directly notify other agencies when it issues warning letters, pointing instead to its online database, which is accessible to both government officials and the public. "The FDA's decisions are intended to be patient-centric with the health and safety of device users as our highest priority," the agency spokesperson said in an email.

The HeartWare letter was removed from the public database about two years ago, even though the problems remained unresolved and patients were still receiving implants. The database clears out letters that are more than five years old.



Therapeutic Modality ,Monitoring and other Devices ,Defibrillators