MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-21 for MOSAIC PORCINE HEART VALVE 31003101 manufactured by Medtronic Heart Valve Division.
[186751697]
Product analysis: no product was returned. Conclusion: without the return of the product, no definitive conclusion can be made regarding the clinical observation. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[186751698]
Medtronic received information that 18 years and 10 months post implant of this 31mm mitral bioprosthetic valve, it was explanted and replaced with a 31mm mitral bioprosthetic valve of the same model.? The reason for the replacement was not reported. No additional adverse patient effects were reported.?
Patient Sequence No: 1, Text Type: D, B5
Report Number | 2025587-2020-00903 |
MDR Report Key | 9863459 |
Report Source | COMPANY REPRESENTATIVE,HEALTH |
Date Received | 2020-03-21 |
Date of Report | 2020-03-21 |
Date of Event | 2020-02-12 |
Date Mfgr Received | 2020-03-13 |
Date Added to Maude | 2020-03-21 |
Event Key | 0 |
Report Source Code | Manufacturer report |
Manufacturer Link | Y |
Number of Patients in Event | 0 |
Adverse Event Flag | 3 |
Product Problem Flag | 3 |
Reprocessed and Reused Flag | 3 |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | PAULA BIXBY |
Manufacturer Street | 8200 CORAL SEA STREET NE |
Manufacturer City | MOUNDS VIEW MN 55112 |
Manufacturer Country | US |
Manufacturer Postal | 55112 |
Manufacturer Phone | 7635055378 |
Manufacturer G1 | MEDTRONIC HEART VALVE DIVISION |
Manufacturer Street | 1851 E DEERE AVE |
Manufacturer City | SANTA ANA CA 92705 |
Manufacturer Country | US |
Manufacturer Postal Code | 92705 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | MOSAIC PORCINE HEART VALVE |
Generic Name | HEART-VALVE, NON-ALLOGRAFT TISSUE |
Product Code | LWR |
Date Received | 2020-03-21 |
Model Number | 31003101 |
Catalog Number | 31003101 |
Operator | HEALTH PROFESSIONAL |
Device Availability | N |
Device Eval'ed by Mfgr | * |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | MEDTRONIC HEART VALVE DIVISION |
Manufacturer Address | 1851 E DEERE AVE SANTA ANA CA 92705 US 92705 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 1. Required No Informationntervention | 2020-03-21 |