BEUDAMED
    FDA Adverse Event Death Summary report: N

    CYPHER

    MDR report key: 556385 · Received September 20, 2004

    Report

    Report Number
    MW1033285
    Event Type
    Death
    Date Received
    September 20, 2004
    Date of Event
    September 12, 2004
    Report Date
    September 20, 2004
    Manufacturer
    J AND J CORDIS
    Product Code
    NIQ
    Adverse Event
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NJ, US
    Reporter Occupation
    NURSING ASSISTANT

    Narratives

    Description of Event or Problem · 1

    PT EXPERIENCED ACUTE CHEST PAIN AND BREATHLESSNESS AT 11:40 PM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CYPHER STENT NIQ J AND J CORDIS * *

    Patients

    Seq Age Sex Outcome Treatment
    1 63 YR Death