FDA Adverse Event Malfunction Summary report: N

SMART CONTROL NITINOL STENT SYSTEM

MDR report key: 1022094 · Received March 25, 2008

Report

Report Number
9616099-2008-00786
Event Type
Malfunction
Date Received
March 25, 2008
Date of Event
February 26, 2008
Report Date
February 28, 2008
Manufacturer
CORDIS DE MEXICO
Product Code
NIO
PMA / PMN Number
P020036
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ALL THE INSTRUCTION FOR USE (IFU) GUIDELINES WAS UTILIZED DURING PREP, AND ATTEMPTED UTILIZATION OF THE PRODUCT. PRIOR TO SHIPPING, THERE WERE NO OTHER ISSUES WITH THE UNIT. THE PRODUCT WAS NOT UTILIZED IN THE PT. NO FURTHER INFO WAS AVAILABLE. ADD'L INFO WILL BE SUBMITTED WITHIN 30 DAYS.

Description of Event or Problem · 1

DURING PREPPING OF THE 6 X 100 MM SMART STENT, THE STENT STARTED AN INITIAL DEPLOYMENT PRIOR TO PLACING IN THE PT. THE EXPERIENCED PHYSICIAN CONSIDERED THE PRODUCT DEFECTIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SMART CONTROL NITINOL STENT SYSTEM SELF EXPANDING STENTS (NIO) NIO CORDIS DE MEXICO NA 13333060

Patients

Seq Age Sex Outcome Treatment
1 UNK