FDA Adverse Event Malfunction Summary report: N

NEURON DELIVERY CATHETER 070

MDR report key: 1950410 · Received December 14, 2010

Report

Report Number
3005168196-2010-00702
Event Type
Malfunction
Date Received
December 14, 2010
Report Date
November 23, 2010
Manufacturer
PENUMBRA, INC.
Product Code
DQY
PMA / PMN Number
K082290
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE PRODUCT WAS NOT RETURNED FOR EVAL. WITHOUT THE RETURN OF THE DEVICE, THE ROOT CAUSE OF THE PROBLEM CANNOT BE DETERMINED.

Description of Event or Problem · 1

THE HOSPITAL DISCOVERED THAT TWO NEURONS HAD SMASHED TIPS WHEN THE PACKAGES WERE OPENED. THE NEURONS WERE NOT USED IN THE CASE. ANOTHER DEVICE WAS AVAILABLE AND USED TO COMPLETE THE CASE. THIS MDR IS ASSOCIATED WITH MDR #: 3005168196-2010-00703.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEURON DELIVERY CATHETER 070 PERCUTANEOUS CATHETER DQY PENUMBRA, INC. F16213

Patients

Seq Age Sex Outcome Treatment
1