FDA Adverse Event Other Summary report: N

THERASPHERE

MDR report key: 2484801 · Received March 6, 2012

Report

Report Number
8022247-2012-00005
Event Type
Other
Date Received
March 6, 2012
Date of Event
September 15, 2011
Report Date
March 2, 2012
Manufacturer
NORDION (CANADA) INC.
Product Code
NAW
PMA / PMN Number
H980006
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Description of Event or Problem · 1

THE PATIENT HAD Y-90 RADIOEMBOLIZATION ON (B)(6) 2011. THE PATIENT PRESENTED TO THE EMERGENCY ROOM AT (B)(6) HOSPITAL VOMITING BLOOD AND WITH A GI BLEED AND WAS ADMITTED FOR CARE AND GI CONSULT. ABDOMINAL CT SCAN WAS PERFORMED ON (B)(6) 2011, WITH A REPORT OF HYPERDENSE MATERIAL IN THE STOMACH OR LIKELY A SMALL BLEED. THE PATIENT IS PART OF AN IIS FOR THERASPHERE AND SORAFENIB BEING PERFORMED AT (B)(6) UNIVERSITY AND (B)(6) HOSPITAL AND HAS BEEN TAKING SORAFENIB SINCE (B)(6) 2011.

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 52 YR Hospitalization