FDA Adverse Event Malfunction Summary report: N

PROWLER SELECT MICROCATHETERS

MDR report key: 1234064 · Received November 4, 2008

Report

Report Number
1058196-2008-00262
Event Type
Malfunction
Date Received
November 4, 2008
Date of Event
October 7, 2008
Report Date
October 7, 2008
Manufacturer
CORDIS NEUROVASCULAR, INC.
Product Code
KRA
PMA / PMN Number
K021591
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT IS TO BE RETURNED FOR EVALUATION AND TESTING. THIS IS ONE OF TWO PRODUCTS USED ON THE SAME PATIENT. MFR REPORT #1058196-2008-00261 AND 1058196-2008-00262. ADDITIONAL INFORMATION WILL BE SUBMITTED WITHIN 30 DAYS UPON RECEIPT.

Description of Event or Problem · 1

DURING THE ENTERPRISE STENT PLACEMENT, THE SYSTEM GOT STUCK INSIDE PROWLER MICROCATHETER (MC) AND COULD NOT ADVANCE OR RETRACT STENT. ALL OF THE GUIDELINES TO PREP AND FLUSH THE STENT WERE FOLLOWED. THE PHYSICIAN DID FEEL SOME INITIAL FRICTION UPON ADVANCING THE STENT, BUT THE STENT DID ADVANCE EASILY AFTER THAT. THE STENT GOT STUCK AT THE DISTAL TIP OF THE MC.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PROWLER SELECT MICROCATHETERS CES MICROCATHETERS KRA CORDIS NEUROVASCULAR, INC.

Patients

Seq Age Sex Outcome Treatment
1 UNK