FDA Adverse Event Injury Summary report: N

GDC-10 360 SOFT COIL

MDR report key: 1242277 · Received November 19, 2008

Report

Report Number
2939204-2008-00606
Event Type
Injury
Date Received
November 19, 2008
Date of Event
September 20, 2008
Report Date
November 4, 2008
Manufacturer
NEUROVASCULAR DIV, BOSTON SCIENTIFIC CORP
Product Code
HCG
PMA / PMN Number
K042539
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFO WAS RECEIVED FROM THE USER FACILITY. THE PHYSICIAN DID NOT EXPERIENCE ANY ISSUES WITH THE PREPARATION, DEPLOYMENT OR DETACHMENT OF ANY OF THE COILS AND THE COILS WERE USED IN ACCORDANCE WITH THE APPROPRIATE DIRECTIONS FOR USE. THE PHYSICIAN DID NOT ALLEGE ANY MALFUNCTION OR NON CONFORMANCE AGAINST THE COILS USED.

Description of Event or Problem · 1

APPROXIMATELY TEN DAYS AFTER THE SUCCESSFUL EMBOLIZATION OF A BASILAR-SUPERIOR CEREBELLAR ARTERY ANEURYSM, THE PT REPORTED EXPERIENCING HALLUCINATIONS AND NARROWING OF THE FIELD OF VISION. THE PT DID NOT HAVE ANY NERVE COMPRESSION, INCREASED PRESSURE IN THE EYE OF ISCHEMIA. THE PHYSICIAN NOTED THERE WERE MULTIPLE HIGH SIGNALS AROUND THE ANEURYSM ON A MAGNETIC RESONANCE IMAGING (MRI) SCAN. THE PHYSICIAN BELIEVES THAT THE VISUAL DISTURBANCES WERE AN INFLAMMATORY REACTION AFTER THE COIL EMBOLIZATION. IT IS UNK IF THE VISUAL DISTURBANCES HAVE RESOLVED OR IF THE PHYSICIAN TOOK ANY ACTION TO TREAT THE SYMPTOMS. THE PHYSICIAN REPORTED TO BE TAKING A "WAIT AND SEE APPROACH".

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GDC-10 360 SOFT COIL (HCG) DETACHABLE COIL HCG NEUROVASCULAR DIV, BOSTON SCIENTIFIC CORP 347715-SR UNK

Patients

Seq Age Sex Outcome Treatment
1 Other SEVENTEEN MATRIX2 COILS| TEN GDC COILS (BOSTON SCIENTIFIC)| ECHELON MICROCATHETER (EV3)| EXCELSIOR SL10 MICROCATHETER