FDA Adverse Event Injury Summary report: N

PROTEGE RX CAROTID STENTING SYSTEM

MDR report key: 1013112 · Received March 14, 2008

Report

Report Number
2183870-2008-00034
Event Type
Injury
Date Received
March 14, 2008
Date of Event
November 27, 2007
Report Date
March 6, 2008
Manufacturer
EV3 INC.
Product Code
NIM
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REFERENCE MDR 23183870-2008-00035 FOR THE SPIDERFX DEVICE USED IN THIS PROCEDURE.

Description of Event or Problem · 1

PT ENROLLED INTO THE CREATE PAS TRIAL. FOLLOWING STENT PLACEMENT, PT BECAME HYPOTENSIVE AND BRADYCARDIC, AT TIME OF FILTER RETRIEVAL PT DEVELOPED SLURRED SPEECH AND FACIAL DROOPING. AFTER BLOOD PRESSURE AND HEART RATE RETURNED TO NORMAL, SLURRED SPEECH AND FACIAL DROOPING WAS RESOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROTEGE RX CAROTID STENTING SYSTEM NIM EV3 INC. SECX-10-7-40-135 2426313

Patients

Seq Age Sex Outcome Treatment
1 UNK Other COOK SHUTTLE SHEATH