BEUDAMED
    FDA Adverse Event Other Summary report: N

    ST. JUDE MEDICAL

    MDR report key: 527705 · Received October 9, 2003

    Report

    Report Number
    527705
    Event Type
    Other
    Date Received
    October 9, 2003
    Date of Event
    November 21, 2002
    Report Date
    September 26, 2003
    Manufacturer
    ST. JUDE MEDICAL, INC.
    Product Code
    LWQ
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CO, US
    Reporter Occupation
    RISK MANAGER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ST. JUDE MEDICAL ST. JUDE AORTIC VALVE LWQ ST. JUDE MEDICAL, INC. UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Other