FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS-PERIMOUNT PLUS PERICARDIAL BIOPROSTHESIS

MDR report key: 1091926 · Received July 31, 2008

Report

Report Number
6000002-2008-08297
Event Type
Injury
Date Received
July 31, 2008
Date of Event
June 25, 2008
Report Date
July 15, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
LWR
PMA / PMN Number
P860057/S016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED, AFTER AN IMPLANT DURATION OF 38 MONTHS, DUE TO UNK REASONS. IT WAS ADDITIONALLY REPORTED THAT A SECOND DEVICE, MODEL # 4450, WAS EXPLANTED. REFER TO MFR # 6000002-2008-08296. NO FURTHER DETAILS WERE PROVIDED. INFO LEARNED FROM IMPLANT PT REGISTRY.

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 4L1759

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention