FDA Adverse Event Injury Summary report: N

ON-X MITRAL PROSTHETIC HEART VALVE

MDR report key: 2123110 · Received December 8, 2008

Report

Report Number
1649833-2008-00010
Event Type
Injury
Date Received
December 8, 2008
Date of Event
September 24, 2008
Report Date
December 3, 2008
Manufacturer
ON-X LIFE TECHNOLOGIES, INC.
Product Code
LWQ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NURSE

Narratives

Additional Manufacturer Narrative · 1

VALVE REMAINS IN PT AND CANNOT BE EVALUATED.

Description of Event or Problem · 1

PT WAS DISCOVERED TO HAVE A THROMBOSED VALVE WHICH WAS TREATED SUCCESSFULLY WITH THROMBOLYTIC THERAPY. AT THE TIME OF EVENT, THE PT WAS IMPROPERLY ANTICOAGULATED. PT WAS DISCHARGED FROM THE HOSPITAL DOING WELL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ON-X MITRAL PROSTHETIC HEART VALVE MECHANICAL HEART VALVE LWQ ON-X LIFE TECHNOLOGIES, INC. ONXM

Patients

Seq Age Sex Outcome Treatment
1 45 YR Required Intervention