FDA Adverse Event Injury Summary report: N

ZENITH AAA ILIAC LEG GRAFT

MDR report key: 1053316 · Received May 27, 2008

Report

Report Number
1820334-2008-00290
Event Type
Injury
Date Received
May 27, 2008
Date of Event
April 28, 2008
Report Date
April 28, 2008
Manufacturer
COOK, INC.
Product Code
MIH
PMA / PMN Number
P020018
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVAL: STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

A MALE WITH VERY SHORT COMMON ILIACS UNDERWENT INITIAL AAA REPAIR IN 2007. ONE FLEX MAIN BODY AND TWO ILIAC LEG GRAFTS WERE PLACED. DUE TO THE ILIAC LEG GRAFT LANDING TOO CLOSE TO THE BIFURCATION, A TYPE I ENDOLEAK RESULTED. IN 2008, THE PHYSICIAN PLACED ANOTHER ILIAC LEG GRAFT ON THE LEFT SIDE TO RESOLVE THE ENDOLEAK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZENITH AAA ILIAC LEG GRAFT MIH ENDOVASCULAR GRAFT MIH COOK, INC. NA 1966018

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention