FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS PHYSIO ANNULOPLASTY RING

MDR report key: 1202988 · Received October 16, 2008

Report

Report Number
6000002-2008-08961
Event Type
Injury
Date Received
October 16, 2008
Date of Event
September 17, 2008
Report Date
October 10, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
KRH
PMA / PMN Number
K926138
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 6900P VALVE AFTER AN IMPLANT DURATION OF NINE (9) 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 PHYSIO ANNULOPLASTY RING ANNULOPLASTY RING KRH EDWARDS LIFESCIENCES 4450 UNK

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| R