BEUDAMED
    FDA Adverse Event Death Summary report: N

    21015

    MDR report key: 21015 · Received March 1, 1995

    Report

    Report Number
    21015
    Event Type
    Death
    Date Received
    March 1, 1995
    Date of Event
    May 29, 1994
    Report Date
    August 4, 1994
    Manufacturer
    MEDCHEM PRODUCTS, INC.
    Report Source
    User Facility report
    Reporter Location
    MO, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PATIENT ADMITTED TO EVALUATE DEEP COUGH OF 1 MO., UNRESPONSIVE TO ANTIBIOTICS, MEDIOSTINCSCOPY PERFORMED 5/28 FOR LARGE MEDIOSTINALMASS. SUFFERED CEREBAL INFARCTION & DIED AT 0228 ON 5/29/94.EXTENSIVE AUTOPSY FINALIZED 8/1/94, IDENTIFYING AUITENE WEB IN THE RIGHT MIDDLE CEREBRAL ARTERY, LEFT ANTERIOR CEREBRAL ARTERY AND LEPTOMENINGED ARTERIES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MEDCHEM PRODUCTS, INC. UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 18 YR Death