BEUDAMED
    FDA Adverse Event Death Summary report: N

    VENATECH

    MDR report key: 1085883 · Received July 10, 2008

    Report

    Report Number
    1085883
    Event Type
    Death
    Date Received
    July 10, 2008
    Date of Event
    May 13, 2008
    Report Date
    July 2, 2008
    Manufacturer
    B. BRAUN MEDICAL INC.
    Product Code
    DTK
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    IN 2008, AFTER PLACEMENT OF A VENA-TECH LGM FILTER, IT MIGRATED INTO THE RIGHT ATRIUM. THE DECEDENT DIED ON TWO DAYS LATER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 VENATECH VENA CAVA FILTER DTK B. BRAUN MEDICAL INC. LGM 30D/U D-G 3518040

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Death