FDA Adverse Event
Death
Summary report: N
CARPENTIER-MCCARTHY-ADAMS IMR ETLOGIX ANNULOPLASTY RING
MDR report key: 1063282
·
Received June 19, 2008
Report
- Report Number
- 6000002-2008-07665
- Event Type
- Death
- Date Received
- June 19, 2008
- Date of Event
- May 28, 2008
- Report Date
- June 16, 2008
- Manufacturer
- EDWARDS LIFESCIENCES
- Product Code
- KRH
- PMA / PMN Number
- K032250
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DEVICE NOT RETURNED.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE PT EXPIRED IN 2008, AFTER AN IMPLANT DURATION OF 21 DAYS. THE REASON FOR THE PT'S DEMISE IS UNK, AS NO ADD'L INFO WAS PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CARPENTIER-MCCARTHY-ADAMS IMR ETLOGIX ANNULOPLASTY RING | ANNULOPLASTY RING | KRH | EDWARDS LIFESCIENCES | 4100 | 6B0447 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 76 YR | Death |