BEUDAMED
    FDA Adverse Event Death Summary report: N

    SCHNEIDER WALLSTENT

    MDR report key: 172366 · Received June 12, 1998

    Report

    Report Number
    172366
    Event Type
    Death
    Date Received
    June 12, 1998
    Date of Event
    May 28, 1998
    Report Date
    June 12, 1998
    Manufacturer
    SCHNEIDER (USA) WALLSTENT PFIZER MEDICAL TECHNOLOGY GRP
    Product Code
    FAD
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    KS, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    SEPSIS DUE TO ANTERIOR RECTAL PERFORATION RESULTING IN DEATH

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SCHNEIDER WALLSTENT Implant ENTERAL ENDOPROSTHESIS FAD SCHNEIDER (USA) WALLSTENT PFIZER MEDICAL TECHNOLOGY GRP B205510110 NOT AVAILABLE

    Patients

    Seq Age Sex Outcome Treatment
    1 68 YR Death