FDA Adverse Event Death Summary report: N

GRANUFLO

MDR report key: 4995012 · Received August 10, 2015

Report

Report Number
1225714-2015-06107
Event Type
Death
Date Received
August 10, 2015
Date of Event
December 8, 2006
Report Date
July 31, 2015
Manufacturer
FRESENIUS MEDICAL CARE NORTH AMERICA
Product Code
KPO
PMA / PMN Number
K030497
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THIS IS ONE EVENT FOR THE SAME PT INVOLVING TWO SEPARATE PRODUCTS. ADDITIONAL INFO HAS BEEN REQUESTED AND WILL BE SUBMITTED UPON RECEIPT ACCORDINGLY. THE (B)(4) IS BEING USED TO REPORT THE NON-SPECIFIC CARDIAC EVENT AS THERE IS NO CODE AVAILABLE TO CAPTURE THIS EVENT.

Description of Event or Problem · 1

THE PLAINTIFF'S ATTORNEY ALLEGED THAT THE PT EXPERIENCED CARDIAC EVENT AND SUBSEQUENTLY EXPIRED, WHICH IS ALLEGED TO HAVE BEEN CAUSED BY THE PT'S EXPOSURE TO THE PRODUCT ADMINISTERED DURING DIALYSIS TREATMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
522429 GRANUFLO KPO FRESENIUS MEDICAL CARE NORTH AMERICA

Patients

Seq Age Sex Outcome Treatment
1 Death| L