BEUDAMED
    FDA Adverse Event Other Summary report: N

    *

    MDR report key: 502227 · Received December 18, 2003

    Report

    Report Number
    502227
    Event Type
    Other
    Date Received
    December 18, 2003
    Date of Event
    June 1, 2003
    Report Date
    September 1, 2003
    Manufacturer
    BOSTON SCIENTIFIC CORP
    Product Code
    DQO
    Report Source
    User Facility report
    Reporter Location
    TN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    AFTER LEFT VENTRICULAR ANGIOGRAM, THE PHYSICIAN NOTED CARDIAC TAMPONADE. PERICARDIOCENTESIS WAS PERFORMED. THE PT WAS CODED SUCCESSFULLY, AND TRANSPORTED TO SURGERY ON VENTILATOR FOR EMERGENT MVR (MITRAL VALVE REPLACEMENT) FOR REPAIR OF LV (LEFT VENTRICULAR) PERFORATION. THE PT RECOVERED WELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 * 6F BENT PIGTAIL CATHETER DQO BOSTON SCIENTIFIC CORP * *

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Other CARDIAC DRUGS.