FDA Adverse Event Death Summary report: N

CARPENTIER-EDWARDS PERIMOUNT PERICARDIAL BIOPROSTHESIS

MDR report key: 1110883 · Received August 11, 2008

Report

Report Number
6000002-2008-08393
Event Type
Death
Date Received
August 11, 2008
Date of Event
July 24, 2008
Report Date
July 24, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
LWR
PMA / PMN Number
P860057
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PT HAS EXPIRED. THE DATE OF PT'S DEATH AND IMPLANT DURATION ARE UNK, THEREFORE THE AWARE DATE IS BEING USED AS THE OCCURRENCE DATE. IT IS UK IF THE DEATH WAS DEVICE RELATED. IT WAS ADDITIONALLY REPORTED THAT A SECOND DEVICE. MODEL #2700, WAS EXPLANTED. REFER TO MFR #6000002-2008-08390. ALSO, THIRD DEVICE WAS IMPLANTED, MODEL #6900PTFX. REFER TO MFR #6000002-2008-08391.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE LWR EDWARDS LIFESCIENCES 2700 R-08D0847

Patients

Seq Age Sex Outcome Treatment
1 Death