FDA Adverse Event Death Summary report: N

SIMPLEX P-JAPANESE TWIN PACK

MDR report key: 1163050 · Received September 16, 2008

Report

Report Number
9610726-2008-00063
Event Type
Death
Date Received
September 16, 2008
Date of Event
August 13, 2008
Report Date
August 22, 2008
Manufacturer
STRYKER ORTHOPAEDICS LIMERICK
Product Code
LOD
PMA / PMN Number
N17004
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

AN EVALUATION OF THE DEVICE CANNOT BE PERFORMED AS THE DEVICE WAS NOT RETURNED TO THE MFR. IF ADDITIONAL INFO BECOMES AVAILABLE, IT WILL BE SUBMITTED IN A SUPPLEMENTAL REPORT.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING SURGERY, THE PT'S BLOOD PRESSURE SUDDENLY DROPPED AND PT EXPIRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SIMPLEX P-JAPANESE TWIN PACK IMPLANT LOD STRYKER ORTHOPAEDICS LIMERICK NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK Death