FDA Adverse Event Injury Summary report: N

ONYX AVM

MDR report key: 1984149 · Received February 10, 2011

Report

Report Number
2029214-2011-00028
Event Type
Injury
Date Received
February 10, 2011
Date of Event
December 23, 2010
Report Date
January 12, 2011
Manufacturer
EV3 NEUROVASCULAR
Product Code
MFE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE INVOLVED IN THIS EVENT WILL NOT BE RETURNED FOR EVALUATION AS IT WAS CONSUMED IN THE EVENT.(B)(4)

Description of Event or Problem · 1

EMBOLIZATION TREATMENT OF AN AVM. IT WAS REPORTED THE CATHETER RUPTURED DURING ONYX INJECTION AND ONYX WAS OBSERVED IN THE FEEDING VESSEL TO THE AVM. NO PATIENT INJURY REPORTED. SAME EVENT AS MDR# 2029214-2011-00027.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ONYX AVM LIQUID EMBOLIC MFE EV3 NEUROVASCULAR UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Disability