FDA Adverse Event Malfunction Summary report: N

NEURON DELIVERY CATHETER 053

MDR report key: 2093181 · Received April 14, 2011

Report

Report Number
3005168196-2011-00147
Event Type
Malfunction
Date Received
April 14, 2011
Report Date
March 17, 2011
Manufacturer
PENUMBRA, INC.
Product Code
DQY
PMA / PMN Number
K070970
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

CONCLUSION: THIS DEVICE IS AVAILABLE FOR RETURN AND A F/U MDR WILL BE SUBMITTED UPON COMPLETION OF THE DEVICE INVESTIGATION.

Description of Event or Problem · 1

A NEURON DELIVERY CATHETER 053 WAS FOUND TO BE DAMAGED UPON REMOVAL FROM THE PACKAGE. THE DEVICE WAS KINKED AT THE DISTAL PORTION NEAR THE TIP. THE DEVICE WAS NOT USED. A SECOND DEVICE WAS USED, AND THE PHYSICIAN COMPLETED THE CASE SUCCESSFULLY. NO DATE OF EVENT WAS PROVIDED, AS A HOSP REP WAS HOLDING THE PRODUCT IN HER OFFICE FOR SOME TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NEURON DELIVERY CATHETER 053 DQY PENUMBRA, INC.

Patients

Seq Age Sex Outcome Treatment
1