FDA Adverse Event
Injury
Summary report: N
ENROUTE NEUROPROTECTION SYSTEM
MDR report key: 11958521
·
Received June 8, 2021
Report
- Report Number
- 3014526664-2021-00076
- Event Type
- Injury
- Date Received
- June 8, 2021
- Date of Event
- May 7, 2021
- Report Date
- June 8, 2021
- Manufacturer
- SILK ROAD MEDICAL INC.
- Product Code
- NTE
- UDI-DI
- 00811311020829
- PMA / PMN Number
- K153485
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- PHYSICIAN
Narratives
Additional Manufacturer Narrative · 1
THE PRODUCT ASSOCIATED WITH THIS COMPLAINT WAS NOT RETURNED TO THE MANUFACTURER FOR ANALYSIS. A REVIEW OF THE MANUFACTURING RECORDS FOR THIS DEVICE WAS COMPLETED AND NO ISSUES WERE IDENTIFIED THAT COULD HAVE LED TO THE ADVERSE EVENT REPORTED. COMPLAINTS WILL CONTINUE TO BE REVIEWED AND MONITORED FOR TRENDS.
Description of Event or Problem · 1
IT WAS REPORTED THAT AFTER THE COMPLETION OF A RIGHT SIDED TRANSCAROTID ARTERY REVASCULARIZATION (TCAR) PROCEDURE, THE PATIENT EXPERIENCED LEFT SIDED NEGLECT AND HEMIANOPSIA. AN MRI SHOWED THAT IT WAS A RIGHT MIDDLE CEREBRAL ARTERY (MCA) ISCHEMIC STROKE. THE PATIENT'S BLOOD PRESSURES AND HEART RATE WERE STABLE AND WITHIN RECOMMENDED LIMITS THROUGHOUT PROCEDURE AND NO P2Y12 INHIBITOR TESTING HAS BEEN PERFORMED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 853212 | ENROUTE NEUROPROTECTION SYSTEM | TEMPORARY CAROTID CATHETER FOR EMBOLIC CAPTURE | NTE | SILK ROAD MEDICAL INC. | SR-200-NPS | 301660 | 00811311020829 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 78 YR | Disability |