FDA Adverse Event Injury Summary report: N

COVERED C-P STENT

MDR report key: 17527533 · Received August 12, 2023

Report

Report Number
MW5134465
Event Type
Injury
Date Received
August 12, 2023
Report Date
January 17, 2012
Manufacturer
NUMED, INC
Product Code
PNF
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

MEDTRONIC RECEIVED INFORMATION THAT THREE YEARS FOLLOWING VALVE IMPLANT, FLUOROSCOPY CONFIRMED THAT A NON-MEDTRONIC (MANUFACTURER NUMED INC.) SINGLE WIRE COVERED C-P STENT FRAGMENT EMBOLIZED TO THE RIGHT PULMONARY ARTERY. NO INTERVENTION WAS DONE AND THE PATIENT WILL BE FOLLOWED UP IN 6 MONTHS. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2182599 COVERED C-P STENT AORTIC STENT PNF NUMED, INC

Patients

Seq Age Sex Outcome Treatment
1 Unknown