FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS PHYSIO ANNULOPLASTY RING WITH DURAFLO TREATMENT

MDR report key: 1063349 · Received June 19, 2008

Report

Report Number
6000002-2008-07626
Event Type
Injury
Date Received
June 19, 2008
Date of Event
May 19, 2008
Report Date
June 13, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
KRH
PMA / PMN Number
K980487
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS IMPLANTED AND EXPLANTED IN 2008, DUE TO AN UNK REASON. NO OTHER INFO WAS FORTHCOMING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PHYSIO ANNULOPLASTY RING WITH DURAFLO TREATMENT ANNULOPLASTY RING KRH EDWARDS LIFESCIENCES 4475 R-08C0565

Patients

Seq Age Sex Outcome Treatment
1 78 YR Required Intervention