BEUDAMED
    FDA Adverse Event Death Summary report: N

    ANGIOJET AVX RHEOLYTIC THROMBECTOMY CATHETER

    MDR report key: 544666 · Received September 20, 2004

    Report

    Report Number
    2183460-2004-00008
    Event Type
    Death
    Date Received
    September 20, 2004
    Date of Event
    August 19, 2004
    Report Date
    September 20, 2004
    Manufacturer
    POSSIS MEDICAL, INC.
    Product Code
    MCW
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    PHYSICIAN NOTED DROP IN PRESSURE. DISCONTINUED AND PRESSURE STABILIZED. STARTED USING ANGIOJET AGAIN AND PRESSURE DROPPED. PT HAD TO BE INTUBATED. PT MOVED TO ICU AND EXPIRED APPROX ONE HOUR LATER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ANGIOJET AVX RHEOLYTIC THROMBECTOMY CATHETER AVX 50 MCW POSSIS MEDICAL, INC. AVX 53119

    Patients

    Seq Age Sex Outcome Treatment
    1 67 YR Death