BEUDAMED
    FDA Adverse Event Death Summary report: N

    ABBOTT

    MDR report key: 951137 · Received November 16, 2007

    Report

    Report Number
    MW5004447
    Event Type
    Death
    Date Received
    November 16, 2007
    Date of Event
    November 8, 2007
    Report Date
    November 16, 2007
    Manufacturer
    ABBOTT VASCULAR
    Product Code
    MAF
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BALLOON STENT CATHETER FRACTURE IN AORTA WITH SNARE RETRIEVAL DISSECTION OF L OSTIAL CIRCUMFLEX PREVIOUS CORONARY ARTERY BYPASS -PROTECTED L MAIN-.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ABBOTT RX MULTI LINK VISION STENT 3.0 X 28MM MAF ABBOTT VASCULAR 3.0 X 28MM

    Patients

    Seq Age Sex Outcome Treatment
    1 YR Death