FDA Adverse Event Malfunction Summary report: N

E-LUMINEXX VASCULAR STENT

MDR report key: 2240868 · Received August 5, 2011

Report

Report Number
9681442-2011-00043
Event Type
Malfunction
Date Received
August 5, 2011
Date of Event
July 11, 2011
Report Date
July 15, 2011
Manufacturer
ANGIOMED GMBH & CO. MEDIZINTECHNIK KG
Product Code
NIO
PMA / PMN Number
P080007
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE LOT NUMBER FOR THE DEVICE WAS PROVIDED. A REVIEW OF THE DEVICE HISTORY RECORDS IS CURRENTLY BEING PERFORMED. THE STENT REMAINS IMPLANTED, THEREFORE A SAMPLE EVAL COULD NOT BE PERFORMED. THE INVESTIGATION IS CURRENTLY UNDERWAY.

Description of Event or Problem · 1

IT WAS REPORTED THAT TWO YEARS AFTER IMPLANT IN A BILIARY LOCATION, A STENT FRACTURE WAS IDENTIFIED. ADD'L INFO PENDING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 E-LUMINEXX VASCULAR STENT NIO ANGIOMED GMBH & CO. MEDIZINTECHNIK KG ANTE0360

Patients

Seq Age Sex Outcome Treatment
1