FDA Adverse Event Death Summary report: N

TRAPEASE PERMANENT VENA CAVA FILTER

MDR report key: 505640 · Received January 9, 2004

Report

Report Number
9610978-2004-00019
Event Type
Death
Date Received
January 9, 2004
Date of Event
December 4, 2003
Report Date
January 7, 2004
Manufacturer
CORDIS EUROPA, N.V.
Product Code
DTK
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
VA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

VENA CAVA FILTER MIGRATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRAPEASE PERMANENT VENA CAVA FILTER THROMBECTOMY SYSTEMS DTK CORDIS EUROPA, N.V. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 38 YR Death