FDA Adverse Event
Injury
Summary report: N
CARPENTIER-EDWARDS PHYSIO MITRAL ANNULOPLASTY RING
MDR report key: 1101185
·
Received August 5, 2008
Report
- Report Number
- 6000002-2008-08325
- Event Type
- Injury
- Date Received
- August 5, 2008
- Date of Event
- January 21, 2008
- Report Date
- February 8, 2008
- Manufacturer
- EDWARDS LIFESCIENCES
- Product Code
- KRH
- PMA / PMN Number
- K926138
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NC, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DEVICE NOT RETURNED. UNSUCCESSFUL RING REPAIR.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE DEVICE WAS IMPLANTED AND EXPLANTED IN 2008, DUE TO AN UNSUCCESSFUL RING REPAIR. IT WAS ADDITIONALLY REPORTED THAT A SECOND DEVICE, MODEL #4200, WAS EXPLANTED. REFER TO MDR #6000002-2008-08326.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CARPENTIER-EDWARDS PHYSIO MITRAL ANNULOPLASTY RING | ANNULOPLASTY RING | KRH | EDWARDS LIFESCIENCES | 4450 | R-07H1650 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Required Intervention |