FDA Adverse Event
Injury
Summary report: N
CARPENTIER-EDWARDS CLASSIC ANNULOPLASTY RING
MDR report key: 1202985
·
Received October 16, 2008
Report
- Report Number
- 6000002-2008-08947
- Event Type
- Injury
- Date Received
- October 16, 2008
- Date of Event
- May 20, 2008
- Report Date
- September 29, 2008
- Manufacturer
- EDWARDS LIFESCIENCES
- Product Code
- KRH
- PMA / PMN Number
- K912554
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- JA
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DEVICE NOT RETURNED.
Description of Event or Problem · 1
REPORTEDLY THE DEVICE WAS EXPLANTED AND REPLACED BY A DIFFERENT MODEL RING #4900T26 AFTER AN IMPLANT DURATION OF 282 MONTHS DUE TO UNK REASONS. NO FURTHER DETAILS WERE PROVIDED. THE DEVICE WILL NOT BE RETURNED (DISCARDED).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | CARPENTIER-EDWARDS CLASSIC ANNULOPLASTY RING | ANNULOPLASTY RING | KRH | EDWARDS LIFESCIENCES | 4500T | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization| R |