FDA Adverse Event Other Summary report: N

PULMONARY VALVE AND CONDUIT SG

MDR report key: 1571865 · Received December 15, 2009

Report

Report Number
1063481-2009-00028
Event Type
Other
Date Received
December 15, 2009
Date of Event
December 11, 2009
Report Date
December 15, 2009
Manufacturer
CRYOLIFE, INC.
Product Code
MIE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS INVESTIGATION IS CURRENTLY ONGOING. ANY ADD'L INFO WILL BE PROVIDED IN THE F/U REPORT.

Description of Event or Problem · 1

ACCORDING TO THE REPORT, WHILE THE SYNERGRAFT PULMONARY VALVE AND CONDUIT WAS BEING IMPLANTED ONE OF THE VALVE LEAFLETS PROLAPSED BUT WAS REPAIRED. THE ALLOGRAFT REMAINS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PULMONARY VALVE AND CONDUIT SG HEART VALVE ALLOGRAFT MIE CRYOLIFE, INC. SGPV00

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention