FDA Adverse Event Death Summary report: N

CORONARY IMAGING CATHETER

MDR report key: 299334 · Received October 9, 2000

Report

Report Number
6000084-2000-00002
Event Type
Death
Date Received
October 9, 2000
Date of Event
September 5, 2000
Report Date
October 7, 2000
Manufacturer
SCIMED. A DIV OF BSC
Product Code
DQO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

THE REPORT TO THE MFR DESCRIBED: "FIVE MINUTES AFTER SUCCESSFULLY IMAGING, THE PT EXPERIENCED LOSS OF BLOOD PRESSURE AND "WENT INTO DEFIB". PT WAS SENT TO SURGERY AND IS STILL ON BALLOON PUMP. IT IS UNCLEAR HOW THE CATHETER PERFORMANCE WAS RELATED TO THE INCIDENT." A FOLLOW UP WAS MADE ON 09/27/2000, AND THE FOLLOWING INFO WAS OBTAINED FROM THE PHYSICIAN: PT EXPIRED ON 09/25/2000. THE IMAGING CATHETER DID NOT CONTRIBUTE TO THE OCCURRENCE. THE CATHETER WAS NOT PRESENT (IN PT) AT THE TIME OF INCIDENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CORONARY IMAGING CATHETER INTRAVASCULAR ULTRASOUND CATHETER SYSTEM DQO SCIMED. A DIV OF BSC C2018 UNK

Patients

Seq Age Sex Outcome Treatment
1 65 YR Death