BEUDAMED
    FDA Adverse Event Death Summary report: N

    ENDO LOGIX

    MDR report key: 956279 · Received November 7, 2007

    Report

    Report Number
    956279
    Event Type
    Death
    Date Received
    November 7, 2007
    Date of Event
    October 26, 2006
    Report Date
    November 1, 2006
    Manufacturer
    ENDO LOGIX
    Product Code
    MIH
    Report Source
    User Facility report
    Reporter Location
    KY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PATIENT TO OR FOR ANEURYSM. ENDO VASCULAR GRAFT DEVICE FRACTURED, AND THE SHEATH IN THE UPPER PORTION OF THE DEVICE SEPARATED, SO THAT THE MAIN BODY COULD NOT BE DEPLOYED ANY FURTHER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 ENDO LOGIX VASCULAR GRAFT MIH ENDO LOGIX 28-16-155 BL W06-0658

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Death