FDA Adverse Event Injury Summary report: N

SPIDERFX EMBOLIC PROTECTION DEVICE

MDR report key: 1020360 · Received March 27, 2008

Report

Report Number
2183870-2008-00038
Event Type
Injury
Date Received
March 27, 2008
Date of Event
February 28, 2008
Report Date
March 20, 2008
Manufacturer
EV3 INC.
Product Code
NTE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

REFERENCE MDR 2183870-2008-00039 FOR THE PROTEGE RX USED IN THIS PROCEDURE.

Description of Event or Problem · 1

PT ENROLLED INTO THE TRIAL: TIA (NEW NEUROLOGICAL DEFICIT LASTING MORE THAN 10 MINUTES BUT <24 HRS) DURING STENT PLACEMENT, PT BECAME AGITATED, UNRESPONSIVE, MOVING ALL FOUR EXTREMITIES. ANGIO SHOWED PATENCY OF STENT AND NO CUT-OFF INTRACRANIAL VESSELS. PT DID SLOWLY IMPROVE OVER 20 MINUTES. PT IS EXPERIENCING BRADYCARDIA THAT IS REQUIRING MEDICATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SPIDERFX EMBOLIC PROTECTION DEVICE NTE EV3 INC. SPD2-US-070-320 3037844

Patients

Seq Age Sex Outcome Treatment
1 76 YR Required Intervention