FDA Adverse Event Injury Summary report: N

ANGIOGUARD XP EMBOLI CAPTURE GUIDEWIRE SYSTEM

MDR report key: 1003566 · Received February 25, 2008

Report

Report Number
1016427-2008-00043
Event Type
Injury
Date Received
February 25, 2008
Date of Event
January 30, 2008
Report Date
January 30, 2008
Manufacturer
CORDIS CORPORATION
Product Code
NTE
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT IS NOT AVAILABLE FOR EVAL AND TESTING. ADD'L INFO TO BE SUBMITTED 30 DAYS UPON RECEIPT. PLEASE NOTE THAT THIS MEDWATCH REPORT REPRESENTS ON OF TWO CORDIS PRODUCTS THAT WAS INVOLVED IN THE SAME PROCEDURE AND IS RELATED TO MFG#9616099-2008-00441 AND 1016427-2008-00043.

Description of Event or Problem · 1

THE PT DEVELOPED A BRAIN INFARCTION WHEN DISTAL EMBOLIZATION OCCURRED DURING A CAROTID STENTING PROCEDURE. THE PT IS A MALE. THE TARGET LESION WAS THE CAROTID ARTERY (SIDE UNK). THERE IS NO INFO REGARDING THE TARGET LESION CHARACTERISTICS. THE DIAMETER OF THE VESSEL IS UNK. IT IS UNK IF THE LESION WAS PRE-DILATED. AN ANGIOGUARD DISTAL PROTECTION DEVICE WAS IN PLACE IN THE VESSEL, AND A PRECISE STENT HAD BEEN SUCCESSFULLY DEPLOYED IN THE LESION WHEN THE EVENT OCCURRED. ARGATROBAN, CLOPIDOGREL, AND ASPIRIN WERE GIVEN INTRA PROCEDURE AND AFTER THE EVENT OCCURRED. IT WAS NOTED THAT ON THE SAME DAY OF THE PROCEDURE, THE PT HAD A SEIZURE, AND INTUBATION WAS NEEDED. THE PT IS RECOVERING, BUT MILD PARALYSIS ON RIGHT LIMB REMAINS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ANGIOGUARD XP EMBOLI CAPTURE GUIDEWIRE SYSTEM EMBOLIC PROTECTION DEVICE NTE CORDIS CORPORATION NA 70107508

Patients

Seq Age Sex Outcome Treatment
1 78 YR Life Threatening| R