BEUDAMED
    FDA Adverse Event Death Summary report: N

    C-QUR

    MDR report key: 2596059 · Received May 25, 2012

    Report

    Report Number
    MW5025564
    Event Type
    Death
    Date Received
    May 25, 2012
    Date of Event
    November 8, 2011
    Report Date
    May 25, 2012
    Manufacturer
    ATRIUM MEDICAL CORPORATION
    Product Code
    FTL
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    CA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    POST-OPERATIVE WOUND INFECTION AND CELLULITIS FOLLOWING VENTRAL HERNIA REPAIR WITH MESH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 C-QUR V-PATCH DIM 6.4 CM X 6.4 CM FTL ATRIUM MEDICAL CORPORATION 10752136089

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Death