FDA Adverse Event Malfunction Summary report: N

MICRUS MICROCOIL SYSTEM

MDR report key: 1162288 · Received September 5, 2008

Report

Report Number
2954740-2008-00004
Event Type
Malfunction
Date Received
September 5, 2008
Date of Event
August 6, 2008
Report Date
August 7, 2008
Manufacturer
MICRUS ENDOVASCULAR CORPORATION
Product Code
HCG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS NOT RETURNED FROM EVAL. THE MFG RECORDS FOR THIS LOT WERE REVIEWED AND DID NOT REVEAL ANY OUTSTANDING DISCREPANCIES, DESIGN OR QUALITY CONCERNS.

Description of Event or Problem · 1

AFTER THE COILING, NOTICED A DISSECTION IN THE CAROTID ARTERY AND ENDED UP STENTING THE CAROTID.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MICRUS MICROCOIL SYSTEM EMBOLIC COIL HCG MICRUS ENDOVASCULAR CORPORATION NEUROPATH F38475

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention