BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CARPENTIER-MCCARTHY-ADAMS IMR ETLOGIX ANNUPLASTY RING

    MDR report key: 1063372 · Received June 19, 2008

    Report

    Report Number
    6000002-2008-07670
    Event Type
    Injury
    Date Received
    June 19, 2008
    Date of Event
    May 22, 2008
    Report Date
    June 16, 2008
    Manufacturer
    EDWARDS LIFESCIENCES
    Product Code
    KRH
    PMA / PMN Number
    K0302250
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    PHYSICIAN

    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 DETAILS WERE PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CARPENTIER-MCCARTHY-ADAMS IMR ETLOGIX ANNUPLASTY RING ANNUPLASTY RING KRH EDWARDS LIFESCIENCES 4100 5K1896

    Patients

    Seq Age Sex Outcome Treatment
    1 59 YR Required Intervention