FDA Adverse Event Death Summary report: N

CARPENTIER-EDWARDS PERIMOUNT MAGNA PERICARDIAL BIOPROSTHESIS

MDR report key: 1953321 · Received January 7, 2011

Report

Report Number
2015691-2011-14638
Event Type
Death
Date Received
January 7, 2011
Date of Event
October 4, 2010
Report Date
December 9, 2010
Manufacturer
EDWARDS LIFESCIENCES
Product Code
DYE
PMA / PMN Number
P860057/S022
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4) THROMBOCYTOPENIA. ADDITIONAL MANUFACTURER NARRATIVE: THE DEVICE HISTORY RECORD (DHR) REVIEW WAS COMPLETED AND THERE WAS NO NONCONFORMANCE FOUND RELATED TO THIS EVENT.

Additional Manufacturer Narrative · 1

DEVICE NOT RETURNED. ADDITIONAL MANUFACTURER NARRATIVE: THE DEVICE HISTORY RECORD (DHR) IS CURRENTLY IN PROCESS.

Description of Event or Problem · 1

EDWARDS LIFESCIENCES MAINTAINS AN IMPLANT PATIENT REGISTRY. THIS REGISTRY IS A PATIENT TRACKING MECHANISM FOR SERIALIZED EDWARDS IMPLANTABLE DEVICES (BIOPROSTHETIC HEART VALVES AND ANNULOPLASTY RINGS), RATHER THAN A TRUE POST-MARKET SURVEILLANCE REGISTRY. THROUGH THE REGISTRY, EDWARDS IS NOTIFIED WHEN THESE DEVICES ARE IMPLANTED. IN ADDITION, PATIENT AND/OR DEVICE STATUS MAY BE REPORTED TO THE REGISTRY VIA THE IMPLANTATION DATA CARDS. THE INFORMATION IS RECEIVED FROM VARIOUS SOURCES (E.G. SURGEON, HOSPITAL, AND PATIENT FAMILY MEMBERS) AND IS NOT RECEIVED IN THE FORM OF A CONVENTIONAL "CUSTOMER COMPLAINT". THE INFORMATION REPORTED MAY OR MAY NOT BE RELATED TO THE EDWARDS DEVICE. IN THIS CASE, IT WAS REPORTED THAT THE PATIENT HAS EXPIRED AFTER AN IMPLANT DURATION OF APPROXIMATELY 1.5 MONTHS. UNFORTUNATELY, THE CAUSE OF DEATH WAS NOT PROVIDED. ACCORDING THE PATIENT'S DISCHARGE SUMMARY, THE PATIENT WAS ADMITTED FOR AORTIC VALVE REPLACEMENT (AVR). STATUS POST AVR, THE PATIENT EXPERIENCED COMPLICATIONS SUCH AS: CHRONIC ATRIAL FIBRILLATION, ANEMIA, THROMBOCYTOPENIA, CARDIOMYOPATHY WITH EF IMPROVED POST SURGERY. ON ECHO, (B)(6) 2010, SHOWED EF OF ABOUT 40%, WHICH WAS IN THE PAST, ABOUT 25%. THE PATIENT ASO HAD ACUTE ON CHRONIC DISEASE STATUS POST TRANSFUSION, HYPERNATREMIA, AND ACUTE RENAL FAILURE. THE PATIENT WAS DISCHARGED TO THE (B)(6) IN STABLE CONDITION. FURTHERMORE, THERE HAS BEEN NO ALLEGATIONS OF A PRODUCT MALFUNCTION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT MAGNA PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE DYE EDWARDS LIFESCIENCES 3000TFX R-10E1360

Patients

Seq Age Sex Outcome Treatment
1 81 YR Death