FDA Adverse Event Injury Summary report: N

CARDIOCEL INTRACARDIAC PATCH

MDR report key: 10782296 · Received November 3, 2020

Report

Report Number
3012664855-2020-00013
Event Type
Injury
Date Received
November 3, 2020
Date of Event
November 16, 2016
Report Date
September 20, 2020
Manufacturer
ADMEDUS REGEN PTY LTD
Product Code
DXZ
PMA / PMN Number
K130872
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

EXPLANT OF AORTIC NEOVALVE IN OZAKI TECHNIQUE WHICH WAS MADE OF CARDIOCEL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1241547 CARDIOCEL INTRACARDIAC PATCH INTRACARDIAC PATCH DXZ ADMEDUS REGEN PTY LTD

Patients

Seq Age Sex Outcome Treatment
1 14 YR Required Intervention