FDA Adverse Event Other Summary report: N

THERASPHERE

MDR report key: 2434674 · Received January 26, 2012

Report

Report Number
8022247-2012-00003
Event Type
Other
Date Received
January 26, 2012
Date of Event
January 6, 2012
Report Date
January 25, 2012
Manufacturer
NORDION (CANADA) INC.
Product Code
NAW
PMA / PMN Number
H980006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE PT PRESENTED TO THE ER ON (B)(6) 2012, COMPLAINING OF SEVERE ABDOMINAL PAIN, NAUSEA AND VOMITING. THE UPPER GI ENDOSCOPY SHOWED "ULCERATION AND DUSKY DISCOLORATION" OF THE LESSER CURVATURE OF THE STOMACH, AND SUSPECTED TO BE ISCHEMIA MOST LIKELY DUE TO RECENT THERASPHERE TREATMENT(S). HE HAD HIS FIRST TREATMENT (B)(6) 2011 (RIGHT LOBE), AND THE SECOND TREATMENT (B)(6) 2011 (LEFT SEGMENT 4A AND 4B). HIS GASTRIC ARTERIES WERE NOT PROPHYLACTICALLY EMBOLIZED DUE TO THE SEGMENTAL TREATMENT PLAN AND THE NORMAL MAA SCAN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 THERASPHERE YTTRIUM-90 MICROSPHERES NAW NORDION (CANADA) INC.

Patients

Seq Age Sex Outcome Treatment
1 Hospitalization