FDA Adverse Event Death Summary report: N

CARPENTIER-EDWARDS PERIMOUNT MAGNA EASE PERICARDIAL BIOPROSTHESIS

MDR report key: 2073150 · Received April 29, 2011

Report

Report Number
2015691-2011-15379
Event Type
Death
Date Received
April 29, 2011
Date of Event
January 3, 2011
Report Date
March 31, 2011
Manufacturer
EDWARDS LIFESCIENCES
Product Code
DYE
PMA / PMN Number
P860057/S042
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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. IT IS UNKNOWN IF THE DEVICE WAS EXPLANTED OR IF AN AUTOPSY WAS DONE. LOCATION AND CAUSE OF DEATH ARE UNKNOWN. THE DHR REVIEW WAS COMPLETED. THIS DEVICE PASSED ALL MANUFACTURING AND STERILIZATION INSPECTIONS WITH NO NONCONFORMANCE.

Additional Manufacturer Narrative · 1

ADDITIONAL MANUFACTURER NARRATIVE: IT HAS BEEN LEARNED THOUGH FOLLOW-UP WITH THE HEALTHCARE PROVIDER THAT THE DEVICE DID NOT CAUSE OR CONTRIBUTE TO THE PATIENT'S DEATH. THIS EVENT WAS REPORTED IN ERROR.

Description of Event or Problem · 1

EDWARDS LIFESCIENCES MAINTAINS AN IMPLANT PATIENT REGISTRY. THIS REGISTRY IS A PATIENT TRACKING MECHANISM FOR STERILIZED 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 7 MONTHS 9 DAYS (7.30 MONTHS) DUE TO UNKNOWN REASONS. IT IS UNKNOWN IF THE DEATH WAS DEVICE RELATED.

Description of Event or Problem · 1

THIS EVENT WAS REPORTED IN ERROR. THROUGH FOLLOW-UP WITH THE HEALTHCARE PROVIDER, IT WAS LEARNED THAT ALTHOUGH THE PATIENT EXPIRED AFTER 7 MONTHS 9 DAYS, THE EDWARD'S VALVE DID NOT CAUSE OR CONTRIBUTE TO THE PATIENT'S DEATH.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARPENTIER-EDWARDS PERIMOUNT MAGNA EASE PERICARDIAL BIOPROSTHESIS REPLACEMENT HEART VALVE DYE EDWARDS LIFESCIENCES 3300TFX 10A001

Patients

Seq Age Sex Outcome Treatment
1 78 YR Death