FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS PERIMOUNT PLUS PERICARDIAL BIOPROSTHESIS

MDR report key: 1081631 · Received July 22, 2008

Report

Report Number
6000002-2008-08145
Event Type
Injury
Date Received
July 22, 2008
Date of Event
July 15, 2008
Report Date
July 16, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
LWR
PMA / PMN Number
P860057S016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SURGEON WENT TO REMOVE THE PATIENT FROM BYPASS, BRIGHT RED BLOOD WAS OBSERVED IN THE PATIENT'S CHEST. THE SURGEON FOUND THAT THE DEVICE STRUT HAD PUNCTURED THE PATIENT'S HEART. THE DEVICE WAS REMOVED AND REPLACED WITH A MECHANICAL VALVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT PLUS PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE LWR EDWARDS LIFESCIENCES 6900P UNK

Patients

Seq Age Sex Outcome Treatment
1 64 YR Required Intervention