FDA Adverse Event Malfunction Summary report: N

MARATHON MICRO CATHETER

MDR report key: 2063386 · Received April 19, 2011

Report

Report Number
2029214-2011-00078
Event Type
Malfunction
Date Received
April 19, 2011
Date of Event
March 23, 2011
Report Date
March 28, 2011
Manufacturer
EV3 NEUROVASCULAR
Product Code
DYG
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE CATHETER HAS BEEN EVALUATED AND A SEPARATION WAS CONFIRMED AT APPROXIMATELY 88.3 CM FROM THE DISTAL TIP OF THE CATHETER. CATHETER SEPARATED. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CATHETER WAS FOUND FRACTURED OUT OF THE PACKAGE. THE DEVICE WAS NOT USED IN THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MARATHON MICRO CATHETER FLOW DIRECTED MICRO CATHETER DYG EV3 NEUROVASCULAR 105-5055 8421484

Patients

Seq Age Sex Outcome Treatment
1