FDA Adverse Event Malfunction Summary report: N

ZENITH FLEX AAA ENDOVASCULAR GRAFT BIFURCATED MAIN BODY

MDR report key: 2170723 · Received June 22, 2011

Report

Report Number
1820334-2011-00308
Event Type
Malfunction
Date Received
June 22, 2011
Date of Event
May 16, 2011
Report Date
May 23, 2011
Manufacturer
COOK, INC.
Product Code
MIH
PMA / PMN Number
P020018
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DIFFICULTY PLACING DUE TO DIFFICULTY SEEING GOLD MARKERS IS NOT SPECIFICALLY ADDRESSED IN THE IFU. EVENT EVAL: STILL UNDER INVESTIGATION.

Description of Event or Problem · 1

MARKERS ON THE DEVICE APPEARED IN AN UNUSUAL MANNER AND DID NOT CLEARLY DEFINE LIMIT OF COVERED STENT (1820334-2011-00308). THIS MADE POSITIONING THE DEVICE DIFFICULT AND CREATED CONCERN ABOUT COVERING THE RENAL ARTERY. ALSO, WITH THE SAME DEVICE, THE CAPTOR VALVE LEAKED LARGE AMOUNTS OF BLOOD, EVEN IN THE CLOSED POSITION (1820334-2011-00309). NO HARM TO THE PT REPORTED. PROCEDURE WAS COMPLETED AND DEVICE REMAINS IN SITU.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ZENITH FLEX AAA ENDOVASCULAR GRAFT BIFURCATED MAIN BODY MIH SYSTEM, ENDOVASCULAR GRAFT, AORTIC ANEURSYM TREATMENT MIH COOK, INC. NA 2696871

Patients

Seq Age Sex Outcome Treatment
1 UNK