FDA Adverse Event Injury Summary report: N

SJM BIOCOR STENTED PORCINE VALVE W/FLEXFIT SYSTEM

MDR report key: 2230492 · Received August 12, 2011

Report

Report Number
3001743903-2011-00055
Event Type
Injury
Date Received
August 12, 2011
Date of Event
July 27, 2011
Report Date
August 12, 2011
Manufacturer
ST. JUDE MEDICAL BRASIL LTDA.
Product Code
LWR
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

SEVERE REGURGITATION WAS OBSERVED ON ECHO AND THE PT HAD GONE INTO HEART FAILURE AS A RESULT; THEREFORE, THE VALVE WAS EXPLANTED AND REPLACED WITH A 29 MM SJM MECHANICAL VALVE IN THE TRICUSPID POSITION. DURING THE EXPLANT PROCEDURE, PANNUS AROUND THE EDGES OF THE VALVE WAS DEBRIDED. THE PT WAS REPORTED TO BE DOING WELL POSTOPERATIVELY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SJM BIOCOR STENTED PORCINE VALVE W/FLEXFIT SYSTEM STENTED TISSUE VALVE LWR ST. JUDE MEDICAL BRASIL LTDA. B100-33M

Patients

Seq Age Sex Outcome Treatment
1 42 YR Hospitalization| R