FDA Adverse Event Injury Summary report: N

ZENITH AAA ENDOVASCUALR GRAFT ILIAC LEG

MDR report key: 1241612 · Received November 21, 2008

Report

Report Number
1820334-2008-00670
Event Type
Injury
Date Received
November 21, 2008
Date of Event
October 31, 2008
Report Date
October 31, 2008
Manufacturer
COOK, INC.
Product Code
MIH
PMA / PMN Number
P020018
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EVENT EVALUATION: STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

A MALE WITH A STRAIGHT FORWARD ANATOMY, UNDERWENT INITIAL AAA REPAIR IN EARLY 2007. ONE MAIN BODY AND TWO ILIAC LEG GRAFTS WERE PLACED. DURING INITIAL IMPLANT, THE PT'S ILIAC MEASURED 18 AND ON F/U IT MEASURED 20-21. PHYSICIAN SUSPECTED AN ENDOLEAK OR CONTINUED ANEURYSM GROWTH, SO IN 2008, THE PHYSICIAN PLACED AN ADD'L ILIAC LEG GRAFT DOWN TO COVER MORE OF THE ILIAC WITH SUCCESS. PT IS DOING FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZENITH AAA ENDOVASCUALR GRAFT ILIAC LEG MIH SYSTEM, ENDOVASCULAR GRAFT, AORTIC ANEURYSM TREATMENT MIH COOK, INC. NA 1779498

Patients

Seq Age Sex Outcome Treatment
1 85 YR Required Intervention