FDA Adverse Event Other Summary report: N

404TT

MDR report key: 1625983 · Received March 5, 2010

Report

Report Number
1718873-2010-00001
Event Type
Other
Date Received
March 5, 2010
Date of Event
July 16, 2002
Report Date
February 23, 2010
Manufacturer
UTAH MEDICAL PRODUCTS, INC.
Product Code
HDB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

UTMD IS FILING THIS REPORT AFTER BEING CONTACTED ON (B)(4) 2010 BY MALPRACTICE ATTORNEY, SEEKING VAD IFU EFFECTIVE ON (B)(4) 2002. PER THE MALPRACTICE ATTORNEY, THERE IS NO ALLEGATION THAT THERE WAS ANY DEFECT WITH THE VACUUM CUP. PRODUCT NOT RETURNED TO UTMD.

Description of Event or Problem · 1

ALLEGED INJURY: BRAIN BLEEDS DURING VAD DELIVERY, SURGERY WAS REQUIRED TO EXCAVATE THE BLOOD CLOTS, RESULTING IN A LONG TERM INJURY OF MOTOR AND COGNITIVE DEFICITS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 404TT VACUUM EXTRACTION CUP HDB UTAH MEDICAL PRODUCTS, INC. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 0 DA Other