FDA Adverse Event Death Summary report: N

SPIDERFX EMBOLIC PROTECTION DEVICE

MDR report key: 1227126 · Received October 29, 2008

Report

Report Number
2183870-2008-00158
Event Type
Death
Date Received
October 29, 2008
Date of Event
February 16, 2008
Report Date
October 16, 2008
Manufacturer
EV3 INC.
Product Code
NTE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PLEASE REFERENCE MDR 2183870-2008-00157 FOR PROTEGE RX USED IN THIS PROCEDURE.

Description of Event or Problem · 1

PT ENROLLED INTO THE TRIAL. RENAL INSUFFICIENCY REPORTED AS WELL AS A MAJOR HEMORRHAGIC STROKE. PT HAD SLURRED TO GARBLED SPEECH, BLANK STARE, RIGHT SIDED FACIAL DROOP. A CT SCAN WHICH SHOWED A "LARGE INTRAPARENCHYMAL HEMORRHAGE" IN RIGHT SUPERIOR PARIETAL LOBE. ACTION TAKEN INCLUDED LABS, EXG, INTUBATION, VENTILATOR, AND MEDICATION CHANGE. PT EXPIRED IN 2008.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SPIDERFX EMBOLIC PROTECTION DEVICE NTE EV3 INC. SPD2-US-060-190 4000717

Patients

Seq Age Sex Outcome Treatment
1 79 YR Death