FDA Adverse Event Malfunction Summary report: N

VOYAGER NC CORONARY DILATATION CATHETER

MDR report key: 1872128 · Received October 14, 2010

Report

Report Number
2024168-2010-02146
Event Type
Malfunction
Date Received
October 14, 2010
Date of Event
September 19, 2010
Report Date
September 20, 2010
Manufacturer
ABBOTT VASCULAR-CARDIAC THERAPIES
Product Code
LOX
PMA / PMN Number
P810046
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS RECEIVED. INVESTIGATION IS NOT COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING DILATATION IN AN UNSPECIFIED VESSEL, THE VOYAGER NC BALLOON RUPTURED AT UNSPECIFIED ATMOSPHERES. THERE WAS NO ADVERSE PATIENT EFFECT. THOUGH REQUESTED, ADDITIONAL INFORMATION WAS NOT PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VOYAGER NC CORONARY DILATATION CATHETER LOX ABBOTT VASCULAR-CARDIAC THERAPIES NA 8100761

Patients

Seq Age Sex Outcome Treatment
1