BEUDAMED
    FDA Adverse Event Death Summary report: N

    V5M

    MDR report key: 1003709 · Received January 15, 2008

    Report

    Report Number
    1003709
    Event Type
    Death
    Date Received
    January 15, 2008
    Date of Event
    February 20, 2007
    Report Date
    March 13, 2007
    Manufacturer
    SIEMENS
    Product Code
    ITX
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT PROCEDURE (TEE) ULTRASOUND, DR COULD NOT SEE ANGLE AND REMOVED PROBE TO EXCHANGE WITH ANOTHER. WHILE WAITING FOR THE OTHER PROBE PT EXPIRED. PROBE WAS SENT TO MFR FOR EVAL. DO NOT BELIEVE PROBE IS CAUSE OF THIS EVENT BUT SENDING THIS REPORT ANYWAY. SEE SCANNED PAGE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 V5M TEE PROBE ITX SIEMENS

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Death