FDA Adverse Event
Death
Summary report: N
REPLACEMENT HEART VALVE
MDR report key: 1113266
·
Received August 11, 2008
Report
- Report Number
- 6000002-2008-08380
- Event Type
- Death
- Date Received
- August 11, 2008
- Date of Event
- July 30, 2008
- Report Date
- July 30, 2008
- Manufacturer
- EDWARDS LIFESCIENCES
- Product Code
- LWR
- PMA / PMN Number
- P860057/S001
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MA, 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 OCCURENCE DATE. IT IS UNK IF THE DEATH WAS DEVICE RELATED. NO FURTHER DETAILS WERE PROVIDED. INFO LEARNED FROM IMPLANT PT REGISTRY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | REPLACEMENT HEART VALVE | LWR | EDWARDS LIFESCIENCES | 2800 | R-08C0612 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Death |