FDA Adverse Event Injury Summary report: N

MARATHON MICRO CATHETER

MDR report key: 2222655 · Received August 25, 2011

Report

Report Number
2029214-2011-00223
Event Type
Injury
Date Received
August 25, 2011
Date of Event
June 20, 2011
Report Date
July 26, 2011
Manufacturer
EV3 NEUROVASCULAR
Product Code
DYG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
ME, US
Reporter Occupation
RISK MANAGER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE INVOLVED IN THE EVENT WILL NOT BE RETURNED FOR EVALUATION.(B)(4)

Description of Event or Problem · 1

TREATMENT OF AN AVM. IT WAS REPORTED THE CATHETER LEAKED DURING ONYX INJECTION. UPON REMOVAL, THE CATHETER BROKE OFF AND THE BROKEN SEGMENT REMAINED IN THE PATIENT. IT WAS REPORTED THE PATIENT EXPERIENCED AN EMBOLIC STROKE. SAME EVENT AS MDR# 2029214-2011-00224.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MARATHON MICRO CATHETER FLOW DIRECTED MICRO CATHETER DYG EV3 NEUROVASCULAR 105-5055 9331668

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization| S