FDA Adverse Event Death Summary report: N

NATURALYTE

MDR report key: 3820270 · Received May 9, 2014

Report

Report Number
1225714-2014-02410
Event Type
Death
Date Received
May 9, 2014
Date of Event
April 21, 2012
Report Date
March 9, 2016
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
KPO
PMA / PMN Number
K070177
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
ATTORNEY

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WAS RECEIVED FROM THE PLAINTIFF'S ATTORNEY REGARDING THE DATE OF EVENT ONSET; HOWEVER, THERE IS A DISCREPANCY AS THE DATE PROVIDED IS DIFFERENT THAN THE DATE THAT WAS INITIALLY REPORTED. ADDITIONAL INFORMATION ASKING FOR CLARIFICATION REGARDING THE DATE OF EVENT ONSET (AS WELL AS THE DATE OF DEATH) HAS BEEN REQUESTED AND WILL BE SUBMITTED UPON RECEIPT ACCORDINGLY. THIS IS ONE OF TWO DEVICE REPORTS FOR THIS EVENT. THE ASSOCIATED MFR REPORT NUMBERS ARE: 1225714-2014-02409 AND 1225714-2014-02410.

Additional Manufacturer Narrative · 1

THIS IS ONE EVENT REPORTED ON THE SAME PATIENT INVOLVING TWO SEPARATE PRODUCTS AND ASSOCIATED WITH MDR 1225714-2014-02409 AND 1225714-2014-02410.

Description of Event or Problem · 1

THE PLAINTIFF'S ATTORNEY ALLEGED THAT THE DECEDENT EXPERIENCED A CARDIOVASCULAR EVENT ON OR ABOUT (B)(6) 2012, SUBSEQUENTLY EXPIRED AFTER THE USE OF THE PRODUCT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
282071 NATURALYTE KPO FRESENIUS MEDICAL CARE NORTH AMERICA

Patients

Seq Age Sex Outcome Treatment
1 Death