FDA Adverse Event Injury Summary report: N

UNKNOWN OPTEASE VENA CAVA FILTER

MDR report key: 2200902 · Received August 11, 2011

Report

Report Number
9616099-2011-00594
Event Type
Injury
Date Received
August 11, 2011
Date of Event
May 16, 2009
Report Date
July 14, 2011
Manufacturer
CORDIS DE MEXICO
Product Code
DTK
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ABSTRACT: WE AIMED TO EVALUATE THE EFFICACY AND SAFETY OF THE OPTEASE AND TRAPEASE (BOTH FROM CORDIS, (B)(4)) VENA CAVA FILTERS IN THE PREVENTION OF PULMONARY EMBOLISM (PE). BETWEEN (B)(6) 2004 AND (B)(6) 2008, OPTEASE (PERMANENT/RETRIEVABLE; N = 228) OR TRAPEASE (PERMANENT; N = 30) VENA CAVA FILTERS WERE PLACED IN 258 PATIENTS (160 FEMALE AND 98 MALE; MEAN AGE 62 YEARS [RANGE 22 TO 97]). INDICATIONS WERE AS FOLLOWS: PROPHYLAXIS FOR PE (N = 239), CONTRAINDICATION FOR ANTICOAGULATION IN THE PRESENCE OF PE OR DVT (N = 10), AND DEVELOPMENT OF PE OR DVT DESPITE ANTICOAGULATION (N = 9). MEDICAL RECORDS WERE RETROSPECTIVELY REVIEWED FOR INDICATIONS, CLINICAL RESULTS, AND PROCEDURE-RELATED COMPLICATIONS DURING PLACEMENT AND RETRIEVAL. CLINICAL PE DID NOT DEVELOP IN ANY OF THE PATIENTS. HOWEVER, RADIOLOGIC SIGNS OF SEGMENTAL PE WERE SEEN IN 6 OF 66 PATIENTS WITH FOLLOW-UP IMAGING DATA. MIGRATION OR FRACTURE OF THE FILTER OR CAVA PERFORATION WAS NOT SEEN IN ANY OF THE PATIENTS. EXCEPT FOR A SINGLE CASE OF ASYMPTOMATIC TOTAL CAVA THROMBOSIS, NO THROMBOTIC OCCLUSION WAS OBSERVED. ONE HUNDRED FORTY-ONE PATIENTS WERE SCHEDULED TO UNDERGO FILTER REMOVAL; HOWEVER, 17 OF THEM WERE NOT SUITABLE FOR SUCH BASED ON VENOGRAPHY EVALUATION. REMOVAL WAS ATTEMPTED IN 124 PATIENTS AND WAS SUCCESSFUL IN 115 OF THESE (MEAN DURATION OF RETENTION 11 DAYS [RANGE 4 TO 23]). NINE FILTERS COULD NOT BE REMOVED. PERMANENT/RETRIEVABLE VENA CAVA FILTERS ARE SAFE AND EFFECTIVE DEVICES FOR PE PROPHYLAXIS AND FOR THE MANAGEMENT OF VENOUS THROMBOEMBOLISM BY PROVIDING THE OPTION TO BE LEFT IN PLACE. CONCLUSION: OPTEASE AND TRAPEASE VENA CAVA FILTERS ARE SAFE AND EFFECTIVE DEVICES FOR PE PROPHYLAXIS AND FOR THE MANAGEMENT OF VTE. THE MOST IMPORTANT LIMITATION OF OPTEASE AS A RETRIEVABLE FILTER IS ITS REQUIREMENT FOR AN EARLY RETRIEVAL. AS SUCCESSFUL RETRIEVAL RATES INCREASE, THE USE OF VENA CAVA FILTERS WILL BECOME MORE COMMON. IT SEEMS POSSIBLE THAT RETRIEVABLE FILTERS MAY ALSO BE USED AS PERMANENT FILTERS WHEN NECESSARY AND THAT THE USE OF PERMANENT FILTERS EVENTUALLY MAY BE COMPLETELY ABANDONED. HOWEVER, FURTHER LONG-TERM AND LARGE-SCALE PROSPECTIVE STUDIES ARE WARRANTED BEFORE A DEFINITE CONCLUSION CAN BE ACHIEVED. OPTEASE AND TRAPEASE VENA CAVA FILTERS: A SINGLE-CENTER EXPERIENCE IN 258 PATIENTS-JOURNAL ARTICLE. WE HAVE CAPTURED THE ADVERSE EVENTS IN THIS ARTICLE AS: PULMONARY EMBOLUS (PE) (6): (B)(4). THE PRODUCT IS NOT AVAILABLE FOR EVALUATION AND TESTING. THE COMPLAINT RECEIVED STATES THAT POST VENA CAVA OPTEASE FILTER IMPLANTATION THE PATIENT DEVELOPED A PULMONARY EMBOLUS. THERE ARE NO PATIENT DEMOGRAPHICS AVAILABLE TO DATE. A LITERATURE SEARCH REVEALED THE FOLLOWING JOURNAL ARTICLE: ONAT ET AL. "OPTEASE AND TRAPEASE VENA CAVA FILTERS: A SINGLE-CENTER EXPERIENCE IN 258 CASES" CARDIOVASC INTERVENT RADIOL (2009) 32:992-997 DOI 10.1007/S00270-009-9591. THERE IS NO STERILE LOT NUMBER INFORMATION AVAILABLE THUS NO DHR COULD BE PERFORMED. RECURRENT EMBOLISM IS A KNOWN POTENTIAL ADVERSE EVENT ASSOCIATED WITH VENA CAVA FILTER IMPLANTATIONS. ALL PRODUCTS UNDERGO A 100% INSPECTION PRIOR TO RELEASE FOR MARKETING. THERE IS NO EVIDENCE OF MANUFACTURING ISSUES THAT MAY HAVE CONTRIBUTED TO THE REPORTED EVENT; THEREFORE, NO CORRECTIVE ACTION IS REQUIRED AT THIS TIME. VENA CAVA FILTERS REPRESENT A TREATMENT NOT A CURE FOR THE FORMATION OF THROMBUS. PATIENTS WHO UNDERGO VENA CAVA FILTER IMPLANTATION ARE USUALLY UNABLE TO BE MAINTAINED ON AN ANTICOAGULATION MEDICATION REGIMEN THUS THE NEED FOR MECHANICAL BLOCKADE OF THE POTENTIAL EMBOLI. THESE PATIENTS CONTINUE TO DEVELOP THROMBOSIS IN THEIR VASCULAR SYSTEMS. THE FILTER IS DESIGNED AS A PROPHYLAXIS AGAINST EMBOLISMS TRAVELING TO THE CENTRAL CIRCULATION I.E. THE HEART, LUNGS AND BRAIN. THE OPTEASE FILTER, AS WELL AS OTHER VENA CAVA FILTERS, IS AN OPEN FRAMEWORK OF METAL STRUTS DESIGNED TO PREVENT EMBOLISMS ABOVE A CERTAIN SIZE FROM TRAVELING FROM THE PERIPHERY TO THE CENTRAL VENOUS SYSTEM. UNFORTUNATELY SMALL THROMBI THAT BREAK LOOSE MAY IN FACT PASS THROUGH THE DEVICE AND TRAVEL TO THE LUNGS; HOWEVER, DUE TO THE VERY SMALL SIZE OF THESE EMBOLI THE PATIENT IS USUALLY ASYMPTOMATIC. IN THIS CASE THE PULMONARY EMBOLI WERE ONLY DISCOVERED BY FOLLOW UP IMAGING, AND NOT CLINICALLY DRIVEN. REVIEW OF THE INFORMATION SUGGESTS THAT PATIENT AND MEDICATION REGIMEN FACTORS MAY HAVE CONTRIBUTED TO THE REPORTED EVENT. PLEASE NOTE THAT THIS IS THE INITIAL/FINAL REPORT FOR THIS PRODUCT.

Description of Event or Problem · 1

A LITERATURE SEARCH REVEALED THE FOLLOWING JOURNAL ARTICLE: ONAT ET AL. "OPTEASE AND TRAPEASE VENA CAVA FILTERS: A SINGLE-CENTER EXPERIENCE IN 258 CASES" CARDIOVASC INTERVENT RADIOL (2009) 32:992-997 DOI 10.1007/S00270-009-9591. THE REPORT/ARTICLE INDICATED THAT A PATIENT HAD RADIOLOGIC SIGNS OF SEGMENTAL PULMONARY EMBOLUS (PE) AS SEEN WITH FOLLOW-UP IMAGING DATA. A TOTAL OF SIX (6) PATIENTS (TOTAL) WERE NOTED IN THE ARTICLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 UNKNOWN OPTEASE VENA CAVA FILTER THROMBECTOMY SYSTEMS (DTK) DTK CORDIS DE MEXICO NA UNK

Patients

Seq Age Sex Outcome Treatment
1