Brand Name | KONECT RESILIA AORTIC VALVED CONDUIT AVC |
Type of Device | HEART-VALVE, NON-ALLOGRAFT TISSUE |
Manufacturer (Section D) |
EDWARDS LIFESCIENCES |
1 edwards way |
irvine CA 92614 |
|
Manufacturer (Section G) |
EDWARDS LIFESCIENCES |
1 edwards way |
|
irvine CA 92614 |
|
Manufacturer Contact |
saurav
singh
|
1 edwards way |
irvine, CA 92614
|
9492506615
|
|
MDR Report Key | 19175173 |
MDR Text Key | 340955250 |
Report Number | 2015691-2024-03113 |
Device Sequence Number | 1 |
Product Code |
LWR
|
UDI-Device Identifier | 00690103193855 |
UDI-Public | (01)00690103193855(17)250913 |
Combination Product (y/n) | N |
Reporter Country Code | US |
PMA/PMN Number | P150048 |
Number of Events Reported | 1 |
Summary Report (Y/N) | N |
Report Source |
Manufacturer
|
Source Type |
Other,Consumer,Health Professional |
Reporter Occupation |
Physician
|
Type of Report
| Initial |
Report Date |
04/24/2024 |
1 Device was Involved in the Event |
|
1 Patient was Involved in the Event |
|
Is this an Adverse Event Report? |
Yes
|
Is this a Product Problem Report? |
No
|
Device Model Number | 11060A25 |
Was Device Available for Evaluation? |
No
|
Is the Reporter a Health Professional? |
Yes
|
Was the Report Sent to FDA? |
No
|
Initial Date Manufacturer Received |
03/30/2024
|
Initial Date FDA Received | 04/24/2024 |
Patient Sequence Number | 1 |
Patient Outcome(s) |
Required Intervention;
Life Threatening;
Hospitalization;
|
Patient Age | 53 YR |
Patient Sex | Male |