FDA Adverse Event Death Summary report: N

ENDOLOGIX POWERLINK SYSTEM

MDR report key: 1033412 · Received April 23, 2008

Report

Report Number
1033412
Event Type
Death
Date Received
April 23, 2008
Date of Event
April 3, 2008
Report Date
April 18, 2008
Manufacturer
ENDOLOGIX, INC
Product Code
MIH
Adverse Event
Yes
Report Source
User Facility report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

ENDOLOGIX BIFURCATED GRAFT INTRODUCER FAILED DURING DEPLOYMENT AND BROKE. A PIECE OF THE DEVICE RETAINED IN AORTA CAUSING NEED TO CONVERT TO OPEN PROCEDURE. MASSIVE BLEEDING. PT ULTIMATELY EXPIRED IN SICU 24 HOURS POST-OP.

Description of Event or Problem · 1

ENDOLOGIX BIFURCATED GRAFT, (B)(4), SERIAL NUMBER (B)(4), INTRODUCER FAILED DURING DEPLOYMENT AND BROKE. A PIECE OF THE DEVICE RETAINED IN AORTA CAUSING NEED TO CONVERT TO OPEN PROCEDURE. MASSIVE BLEEDING. PT ULTIMATELY EXPIRED IN SICU 24 HOURS POST-OP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENDOLOGIX POWERLINK SYSTEM BIFURCATED Y GRAFT MIH ENDOLOGIX, INC 28-16-140BL

Patients

Seq Age Sex Outcome Treatment
1