FDA Adverse Event
Injury
Summary report: N
CARDIOCEL INTRACARDIAC PATCH
MDR report key: 10782191
·
Received November 3, 2020
Report
- Report Number
- 3012664855-2020-00017
- Event Type
- Injury
- Date Received
- November 3, 2020
- Date of Event
- October 2, 2015
- Report Date
- September 27, 2020
- Manufacturer
- ADMEDUS REGEN PTY LTD
- Product Code
- DXZ
- PMA / PMN Number
- K130872
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MN, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
STENOSIS OF RPA AND LPA AND DEGENERATION AND THICKENING OF THE CARDIOCEL TISSUE IN MONOCUSP POSITION.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1241495 | CARDIOCEL INTRACARDIAC PATCH | INTRACARDIAC PATCH | DXZ | ADMEDUS REGEN PTY LTD |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |