FDA Adverse Event Injury Summary report: N

PHENOM

MDR report key: 17795420 · Received September 21, 2023

Report

Report Number
2029214-2023-01820
Event Type
Injury
Date Received
September 21, 2023
Date of Event
April 13, 2022
Report Date
February 6, 2024
Manufacturer
MICRO THERAPEUTICS, INC. DBA EV3
Product Code
KRA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

MEDTRONIC IS SUBMITTING THIS REPORT TO COMPLY WITH FDA REPORTING REGULATIONS UNDER 21 CFR PARTS 4 AND 803. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION AND HAS PROVIDED AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY ¿DEFECTS¿ OR HAS ¿MALFUNCTIONED¿. THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REGULATORY REPORTING. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE THEM BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT.

Additional Manufacturer Narrative · 0

CONTINUATION OF D10: PRODUCT ID UNK-NV-SOLITAIRE (UNKNOWN); PRODUCT TYPE: ; IMPLANT DATE N/A; EXPLANT DATE N/A PRODUCT ID UNK-NV-FG (UNKNOWN); G2: CITATION: AUTHORS: VEGA, P., MURIAS, E., JIMENEZ, J. M., CHAVIANO, J., RODRIGUEZ, J., CALLEJA, S., DELGADO, M., BENAVENTE, L., CASTAÑON, M., PUIG, J., CIGARRAN, H., ARIAS, F., & CHAPOT, R.. FIRST-LINE DOUBLE STENTRIEVER THROMBECTOMY FOR M1/TICA OCCLUSIONS. CLINICAL NEURORADIOLOGY: OFFICIAL JOURNAL OF THE GERMAN, AUS 32(4):971-977 2022. DOI:10.1007/S00062-022-01161-2 EARLIEST DATE OF PUBLICATION USED FOR DATE OF EVENT NO UNIQUE DEVICE IDENTIFIER (SERIAL/LOT) NUMBERS WERE PROVIDED; WITHOUT THIS INFORMATION IT COULD NOT BE DETERMINED WHETHER THESE OBSERVATIONS HAVE BEEN PREVIOUSLY REPORTED. WITHOUT RETURN OF THE PRODUCT NO DEFINITIVE CONCLUSION CAN BE MADE REGARDING THE CLINICAL OBSERVATIONS. SEE MANUFACTURER REPORT 2029214-2023-01817, 2029214-2023-01818, AND 2029214-2023-01819 FOR OTHER REPORTS FROM THIS ARTICLE. MEDTRONIC IS SUBMITTING THIS REPORT TO COMPLY WITH FDA REPORTING REGULATIONS UNDER 21 CFR PARTS 4 AND 803. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION AND HAS PROVIDED AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY ¿DEFECTS¿ OR HAS ¿MALFUNCTIONED¿. THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REGULATORY REPORTING. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE THEM BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 0

MEDTRONIC IS SUBMITTING THIS REPORT TO COMPLY WITH FDA REPORTING REGULATIONS UNDER 21 CFR PARTS 4 AND 803. THIS REPORT IS BASED UPON INFORMATION OBTAINED BY MEDTRONIC, WHICH THE COMPANY MAY NOT HAVE BEEN ABLE TO FULLY INVESTIGATE OR VERIFY PRIOR TO THE DATE THE REPORT WAS REQUIRED BY THE FDA. MEDTRONIC HAS MADE REASONABLE EFFORTS TO OBTAIN MORE COMPLETE INFORMATION AND HAS PROVIDED AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. IN PARTICULAR, THIS REPORT DOES NOT CONSTITUTE AN ADMISSION BY ANYONE THAT THE PRODUCT DESCRIBED IN THIS REPORT HAS ANY ¿DEFECTS¿ OR HAS ¿MALFUNCTIONED¿. THESE WORDS ARE INCLUDED IN THE FDA 3500A FORM AND ARE FIXED ITEMS FOR SELECTION CREATED BY THE FDA TO CATEGORIZE THE TYPE OF EVENT SOLELY FOR THE PURPOSE OF REGULATORY REPORTING. MEDTRONIC OBJECTS TO THE USE OF THESE WORDS AND OTHERS LIKE THEM BECAUSE OF THE LACK OF DEFINITION AND THE CONNOTATIONS IMPLIED BY THESE TERMS. THIS STATEMENT SHOULD BE INCLUDED WITH ANY INFORMATION OR REPORT DISCLOSED TO THE PUBLIC UNDER THE FREEDOM OF INFORMATION ACT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 0

ADDITIONAL INFORMATION WAS RECEIVED THAT NONE OF THE ADVERSE EFFECTS WERE RELATED TO MEDTRONIC DEVICES. NO COMPLICATIONS WERE OBSERVED WITH MEDTRONIC DEVICES AND NO PATIENT WAS HARMED OR DECEASED BECAUSE OF THE DEVICES.

Description of Event or Problem · 0

VEGA P, MURIAS E, JIMENEZ JM, ET AL. FIRST-LINE DOUBLE STENTRIEVER THROMBECTOMY FOR M1/TICA OCCLUSIONS: INITIAL EXPERIENCES. CLINICAL NEURORADIOLOGY: OFFICIAL JOURNAL OF THE GERMAN, AUSTRIAN, AND SWISS SOCIETIES OF NEURORADIOLOGY. 2022;32(4):971-977. DOI:10.1007/S 00062-022-01161-2. MEDTRONIC LITERATURE REVIEW FOUND A REPORT OF PATIENT COMPLICATIONS IN ASSOCIATION WITH A SOLITAIRE STENT RETRIEVER AND PHENOM 21 MI CROCATHETER. THE PURPOSE OF THIS ARTICLE WAS TO DETERMINE THE SAFETY AND EFFICACY OF FIRST-LINE DOUBLE STENTRIEVER THROMBECTOMY FOR ACUTE OCCLUSION OF THE M1 SEGMENT OF THE MIDDLE CEREBRAL ARTERY AND/OR TERMINAL INTERNAL CAROTID ARTERY (TICA). THERE WERE 39 PATIENTS INCLUDED, 23 OF WHICH WERE FEMALE, AND THE MEDIAN AGE WAS 79 YEARS. STENTRIEVERS USED INCLUDED SOLITAIRE X, TREVO NXT OR EMBOTRAP II, THOUGH IT IS UNCLEAR HOW MANY OF EACH DEVICE WERE USED. RECANALIZATION WAS SUCCESSFUL (TICI 2B/3) IN ALL PATIENTS. THE ARTICLE DOES NOT STATE ANY TECHNICAL ISSUES DURING USE OF THE SOLITAIRE OR PHENOM. THE FOLLOWING INTRA- OR POST-PROCEDURAL OUTCOMES WERE NOTED:  - THREE CASES OF SYMPTOMATIC INTRACEREBRAL HEMORRHAGES WERE OBSERVED, WHICH WAS DEFINED AS ANY TYPE OF HEMORRHAGE WITH AN INCREASE OF 4 OR MORE IN NIHSS SCORE.  - CONTRAST EXTRAVASATION WITHOUT A VISIBLE ARTERIAL PERFORATION WAS OBSERVED IN 2 PATIENTS: 1 SUBARACHNOID HEMORRHAGE (FISHER GRADE 3) AND 1 DIRECT CAROTID-CAVERNOUS FISTULA. BOTH RESOLVED SPONTANEOUSLY AFTER THE PROXIMAL BALLOON WAS INFLATED FOR A FEW MINUTES WITHOUT WORSENING THE CLINICAL SITUATION OF THE PATIENTS. IT WAS NOTED THERE WERE 2 TOTAL CASES OF SUBARACHNOID HEMORRHAGE IN THE STUDY.  - EMBOLISMS TO THE SAME TERRITORY WERE OBSERVED IN 3 PATIENTS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
712360 PHENOM CATHETER, CONTINUOUS FLUSH KRA MICRO THERAPEUTICS, INC. DBA EV3 UNK-NV-FG UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 79 YR Female Other SEE H10...