FDA Adverse Event Injury Summary report: N

CARPENTIER-EDWARDS PERIMOUNT PLUS PERICARDIAL BIOPROSTHESIS

MDR report key: 1211484 · Received October 21, 2008

Report

Report Number
6000002-2008-09011
Event Type
Injury
Date Received
October 21, 2008
Date of Event
September 26, 2008
Report Date
October 8, 2008
Manufacturer
EDWARDS LIFESCIENCES
Product Code
LWR
PMA / PMN Number
P860057/S016
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED.

Description of Event or Problem · 1

REPORTEDLY, THE VALVE WAS EXPLANTED DUE TO SEVERE CENTRAL LEAKAGE. IMPLANT/EXPLANT DATE UNKNOWN. VALVE WAS REPLACED BY SAME MODEL AND SIZE DEVICE. PATIENT IS REPORTED TO BE DOING "OK".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT PLUS PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE LWR EDWARDS LIFESCIENCES 6900P UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 UNK Hospitalization| R