BEUDAMED
    FDA Adverse Event Death Summary report: N

    CMW 1 RADIOPAQUE CEMENT

    MDR report key: 379438 · Received March 1, 2002

    Report

    Report Number
    1818910-2002-00103
    Event Type
    Death
    Date Received
    March 1, 2002
    Date of Event
    January 12, 2002
    Report Date
    March 1, 2002
    Manufacturer
    DEPUY CMW
    Product Code
    LOD
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TW
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PATIENT DIED FOLLOWING CEMENTED HIP IMPLANT SURGERY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CMW 1 RADIOPAQUE CEMENT BONE CEMENT LOD DEPUY CMW NA C107R40

    Patients

    Seq Age Sex Outcome Treatment
    1 73 YR Death