BEUDAMED
    FDA Adverse Event Death Summary report: N

    WIKTOR CORONARY STENT DELIVERY SYSTEM

    MDR report key: 122253 · Received September 23, 1997

    Report

    Report Number
    2083093-1997-00050
    Event Type
    Death
    Date Received
    September 23, 1997
    Date of Event
    August 25, 1997
    Report Date
    September 19, 1997
    Manufacturer
    MEDTRONIC INTERVENTIONAL VASCULAR, INC.
    Product Code
    MAF
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    ON 10/1/97, MEDTRONIC LEARNED THAT THE PT HAD EXPIRED THE DAY AFTER THE PROCEDURE, 8/26/97.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 WIKTOR CORONARY STENT DELIVERY SYSTEM Implant CORONARY STENT DELIVERY SYSTEM MAF MEDTRONIC INTERVENTIONAL VASCULAR, INC. 6570 J97224910

    Patients

    Seq Age Sex Outcome Treatment
    1 76 YR Death| R