BEUDAMED
    FDA Adverse Event Injury Summary report: N

    ON-X AORTIC HEART VALVE AND EXTENDER HOLDER - 21MM

    MDR report key: 5995223 · Received October 3, 2016

    Report

    Report Number
    1649833-2016-00024
    Event Type
    Injury
    Date Received
    October 3, 2016
    Date of Event
    January 2, 2014
    Report Date
    October 3, 2016
    Manufacturer
    ON-X LIFE TECHNOLOGIES, INC
    Product Code
    LWQ
    UDI-DI
    00851788001396
    PMA / PMN Number
    P000037
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    IN 2016, ON-X TECHNOLOGIES INCORPORATED (ON-X) BECAME A WHOLLY OWNED SUBSIDIARY OF CRYOLIFE, INC. (CRYOLIFE). A RETROSPECTIVE REVIEW OF THE ON-X COMPLAINT SYSTEM WAS PERFORMED TO IDENTIFY ANY AREAS REQUIRING ADDITIONAL ACTION AND TO APPROPRIATELY ASSIMILATE THE ON-X PROCESS INTO THE CRYOLIFE QUALITY MANAGEMENT SYSTEM. IN AN ABUNDANCE OF CAUTION THIS MDR IS BEING REPORTED TO SATISFY REGULATORY REPORTING OBLIGATIONS. THE ON-X 614 HEART VALVE DESIGN FMEA 940816 01 REV S THOROUGHLY IDENTIFIES THE PROCESS AND PRODUCT HAZARDS FOR APPROVED INDICATIONS. EACH INDIVIDUAL HAZARD IS MITIGATED AND REDUCED AS LOW AS POSSIBLE BY DESIGN AND PROCESS. POST PRODUCTION RESIDUAL RISK IS COMMUNICATED IN THE PRODUCT'S LABELING AND INSTRUCTION FOR USE (IFU). REOPERATION IS A KNOWN COMPLICATION OF PROSTHETIC VALVE IMPLANTATION AND IS LISTED IN THE IFU. WITHOUT RETURN OF THE VALVE, A SPECIFIC RISK CANNOT BE IDENTIFIED. THERE IS NO INDICATION THAT THE PATIENT DEATH WAS RELATED TO THE VALVE.

    Description of Event or Problem · 1

    IMPLANT RECOVERY CARDS RECEIVED INDICATED THAT PATIENT RECEIVED ONXAE-23 ON (B)(6) 2011 WHICH REQUIRED INTERVENTION/EXPLANT ON (B)(6) 2014 AND REPLACEMENT WITH ONXAE-21 FOR UNSPECIFIED REASON. ADDITIONAL INFORMATION RECEIVED VIA PHONE CONVERSATION ON (B)(6) 2016 WITH THE NURSE INDICATED THAT THE PATIENT WAS NOW DECEASED AND NO INFORMATION WOULD BE RELEASED FOR THE PATIENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    646722 ON-X AORTIC HEART VALVE AND EXTENDER HOLDER - 21MM MECHANICAL HEART VALVE LWQ ON-X LIFE TECHNOLOGIES, INC ONXAE-21 00851788001396

    Patients

    Seq Age Sex Outcome Treatment
    1 62 YR Death| O| R