BEUDAMED
    FDA Adverse Event Death Summary report: N

    MEDI. TECH BOSTON SCIENTIFIC CORP.

    MDR report key: 207862 · Received January 26, 1999

    Report

    Report Number
    207862
    Event Type
    Death
    Date Received
    January 26, 1999
    Date of Event
    January 24, 1999
    Report Date
    January 25, 1999
    Manufacturer
    MEDITECH BOSTON SCIENTIFIC CORP
    Product Code
    DTK
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    MA, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT TO OPERATING ROOM FOR GREENFIELD VENA CAVA UMBRELLA. VENA CAVAL PERFORATION WHEN UMBRELLA DEPLOYED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDI. TECH BOSTON SCIENTIFIC CORP. Implant TITANIUM GREENFIELD VENA CAVA FILTER DTK MEDITECH BOSTON SCIENTIFIC CORP * 275772

    Patients

    Seq Age Sex Outcome Treatment
    1 86 YR Death