FDA Adverse Event Death Summary report: N

ANEURX AAADVANTAGE STENT GRAFT SYSTEM

MDR report key: 854938 · Received May 24, 2007

Report

Report Number
2953200-2007-00204
Event Type
Death
Date Received
May 24, 2007
Date of Event
May 2, 2007
Report Date
May 2, 2007
Manufacturer
MEDTRONIC VASCULAR
Product Code
MIH
PMA / PMN Number
P990020
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

EVALUATION RESULTS: INHERENT RISK OF PROCEDURE (DEATH).

Description of Event or Problem · 1

AN ANEURX STENT GRAFT SYSTEM WAS IMPLANTED INTO A PATIENT FOR THE ENDOVASCULAR TREATMENT OF AN ABDOMINAL AORTIC ANEURYSM. IT WAS REPORTED THAT THE STENT GRAFT WAS SUCCESSFULLY IMPLANTED. THE PATIENT TOLERATED THE PROCEDURE WELL AND WAS TAKEN TO THE RECOVERY ROOM. WHILE IN THE RECOVERY ROOM, THE PATIENT HAD A MILD INJECTION FRACTION AND EXPIRED. IT WAS REPORTED TO MEDTRONIC THAT THE PHYSICIAN DOES NOT BELIEVE THE DEATH WAS DEVICE OR PROCEDURE RELATED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANEURX AAADVANTAGE STENT GRAFT SYSTEM MIH MEDTRONIC VASCULAR NA 1000044

Patients

Seq Age Sex Outcome Treatment
1 71 YR Death