FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS PERIMOUNT RSR PERICARDIAL BIOPROSTHESIS

MDR report key: 1201750 · Received October 14, 2008

Report

Report Number
6000002-2008-08922
Event Type
Injury
Date Received
October 14, 2008
Date of Event
September 22, 2008
Report Date
September 22, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
LWR
PMA / PMN Number
P860057S001
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AZ, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN EVALUATED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED AFTER AN IMPLANT DURATION OF 67 MONTHS, DUE TO LEAFLET CALCIFICATION. REPORTEDLY, THE LEAFLETS WOULD NOT MOVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT RSR PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE LWR EDWARDS LIFESCIENCES 2800 2L2053

Patients

Seq Age Sex Outcome Treatment
1 62 YR Required Intervention