FDA Adverse Event Death Summary report: N

CELLEX

MDR report key: 1831784 · Received September 10, 2010

Report

Report Number
2523595-2010-00010
Event Type
Death
Date Received
September 10, 2010
Date of Event
August 25, 2010
Report Date
September 3, 2010
Manufacturer
THERAKOS
Product Code
LNR
PMA / PMN Number
P860003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

IT IS UNLIKELY THE ECP TREATMENT CONTRIBUTED TO THE DEATH AS THE UNDERLYING DIAGNOSIS OF PT WAS DESCRIBED AS BEING THE POTENTIAL CAUSE. THE CUSTOMER AGREED TO RETURN THE DATA FILE TO CONFIRM APPROPRIATE OPERATION. (B)(4).

Description of Event or Problem · 1

THE PT WAS BEING TREATED FOR GVHD. HER LAST TREATMENT WAS ON (B)(6)2010. THE ATTENDING PHYSICIAN REPORTED, THE DEATH APPEARED TO BE A RESULT OF THE UNDERLYING CONDITION OF THE PT, AND NOT THE TREATMENT NOR THE ADMINISTRATION OF METHOXSALEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CELLEX CELLEX LNR THERAKOS CELLEX

Patients

Seq Age Sex Outcome Treatment
1 4 YR Death UVADEX, PER ECP TREATMENT, LOT# 1831401| METHOXSALEN