FDA Adverse Event Death Summary report: N

CARPENTIER-EDWARDS S.A.V. BIOPROSTHESIS

MDR report key: 2001468 · Received February 25, 2011

Report

Report Number
2015691-2011-14890
Event Type
Death
Date Received
February 25, 2011
Date of Event
July 30, 2010
Report Date
January 27, 2011
Manufacturer
EDWARDS LIFESCIENCES
Product Code
DYE
PMA / PMN Number
P010041
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL MANUFACTURER NARRATIVE: THE DEVICE HISTORY RECORD (DHR) REVIEW WAS COMPLETED AND THIS DEVICE PASSED ALL MANUFACTURING AND STERILIZATION INSPECTIONS WITH NO NONCONFORMANCE.

Additional Manufacturer Narrative · 1

METHOD: DEVICE NOT RETURNED. ADDITIONAL MANUFACTURER NARRATIVE: DESPITE OUR ATTEMPTS TO RECEIVE FURTHER INFORMATION REGARDING THE DEVICE AND EVENT, NO RESPONSE OR SAMPLE FOR EVALUATION WAS RECEIVED FROM THE HEALTH-CARE PROVIDER. NO CAUSE OF DEATH WAS PROVIDED. IT IS UNKNOWN IF THE DEVICE WAS EXPLANTED OR IF AN AUTOPSY WAS DONE. A DEVICE HISTORY RECORD REVIEW IS IN PROGRESS.

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, THE PATIENT EXPIRED AFTER AN IMPLANT DURATION OF ZERO DAYS DUE TO UNKNOWN REASONS. NO CAUSE OF DEATH WAS PROVIDED. IT IS UNKNOWN IF THE DEATH WAS DEVICE RELATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS S.A.V. BIOPROSTHESIS REPLACEMENT HEART VALVE DYE EDWARDS LIFESCIENCES 2650 10C056

Patients

Seq Age Sex Outcome Treatment
1 74 YR Death| H| R