FDA Adverse Event Death Summary report: N

CARPENTER EDWARDS BIOPROSTHESIS #35

MDR report key: 1724 · Received October 22, 1992

Report

Report Number
1724
Event Type
Death
Date Received
October 22, 1992
Date of Event
July 2, 1992
Manufacturer
AMERICAN EDWARDS LABORATORIES
Product Code
DYE
Adverse Event
Yes
Report Source
User Facility report

Narratives

Description of Event or Problem · 1

11/4/85 THE PATIENT UNDERWENT CAB SURGERY AND INSERTION OF A PROSTHETIC MITRAL VALVE, CARPENTER-EDWARDS. ON 6/3/92 THE PATIENT UNDERWENT A HEART CATH. THE IMPRESSION: PREVIOUS MITRAL VALVE REPLACEMENT WITH 4+ MITRAL INSUFFICIENCY, ASSOCIATED PULMONARY HYPERTENSION. ON 6/10/92 THE PATIENT UNDERWENT EXPLANATION OF PREVIOUSLY PLACED PORCINE BIOPROSTHESIS AND INSERTION OF NEW MEDTRONIC MECHANICAL MITRAL PROSTHESIS AND CAB. POST-OP THE PATIENT CONTINUED TO DETERIORATE. THE PATIENT EXPIRED 7/2/92. FINAL DX WIDE OPEN MITRAL INSUFFICIENCY SECONDARY TO PREVIOUSLY PLACED PORCINE VITRAL PROSTHESIS IN THE MITRAL AREADEVICE LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: FAIR CONDITION. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, VISUAL EXAMINATION. RESULTS OF EVALUATION: COMPONENT FAILURE, LEAFLET. CONCLUSION: DEVICE FAILURE DIRECTLY CONTRIBUTED TO EVENT. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: YES. CORRECTIVE ACTIONS: DEVICE DISCARDED. THE DEVICE WAS DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTER EDWARDS BIOPROSTHESIS #35 Implant MITRAL VALVE DYE AMERICAN EDWARDS LABORATORIES 6625 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 76 YR Death