FDA Adverse Event Malfunction Summary report: N

TRAPEASE PERMANENT VENA CAVA FILTER

MDR report key: 1031361 · Received April 17, 2008

Report

Report Number
9610978-2008-00101
Event Type
Malfunction
Date Received
April 17, 2008
Date of Event
March 26, 2008
Report Date
March 26, 2008
Manufacturer
CORDIS EUROPA, N.V.
Product Code
DQO
PMA / PMN Number
K020316
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

A TRAPEASE FILTER WAS INSERTED INTO THE PATIENT AT A HOSPITAL IN MID 2000. THE PHYSICIAN THAT HAS NOW TAKEN OVER THE CARE OF THIS PATIENT HAS NOTICED THAT THE FILTER HAS FRAGMENTED. HE BELIEVES THAT THIS WAS FIRST EVIDENT IN 2006 AND HAS BEEN MONITORING THE PATIENT. THE PRODUCT IS NOT AVAILABLE FOR EVALUATION AND TESTING AS IT REMAINS IMPLANTED IN THE PATIENT. ADDITIONAL INFORMATION WILL BE SUBMITTED WITHIN 30 DAYS OF RECEIPT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRAPEASE PERMANENT VENA CAVA FILTER THROMBECTOMY SYSTEMS - DQO DQO CORDIS EUROPA, N.V. NA UNK

Patients

Seq Age Sex Outcome Treatment
1 UNK