BEUDAMED
    FDA Adverse Event Death Summary report: N

    TRAP-EASE

    MDR report key: 533876 · Received July 1, 2004

    Report

    Report Number
    533876
    Event Type
    Death
    Date Received
    July 1, 2004
    Date of Event
    June 14, 2004
    Report Date
    June 24, 2004
    Manufacturer
    CORIDS J & J
    Product Code
    DTK
    Adverse Event
    Yes
    Report Source
    User Facility report
    Reporter Location
    CA, US
    Reporter Occupation
    NURSE

    Narratives

    Description of Event or Problem · 1

    IN 2004 A TRAP-EASE IVC FILTER WAS PLACED IN PT DUE TO PULMONARY EMBOLISM. SAME DAY FINAL IMAGE INDICATED GOOD POSITION OF FILTER AT THE L2 LEVEL. PT DISCHARGED TO HOME FIVE DAYS LATER. PT EXPIRED THE NEXT DAY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRAP-EASE IVC FILTER DTK CORIDS J & J * *

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Death