FDA Adverse Event Malfunction Summary report: N

INTERGARD WOVEN

MDR report key: 24922282 · Received April 20, 2026

Report

Report Number
1640201-2026-0000021
Event Type
Malfunction
Date Received
April 20, 2026
Date of Event
March 10, 2026
Report Date
May 22, 2026
Manufacturer
INTERVASCULAR SAS
Product Code
DSY
UDI-DI
00384401000259
PMA / PMN Number
K984294
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

(10/3233) IT WAS REPORTED THAT THE PRODUCT IS AVAILABLE FOR INVESTIGATION, IT SHOULD BE RETURNED TO INTERVASCULAR FOR EXAMINATION. (4109/213) THE REVIEW OF HISTORICAL DATA INDICATED THAT NO OTHER SIMILAR COMPLAINT WAS REPORTED FOR THE SAME STERILIZATION LOT NUMBER 25F12. (11) THE INVESTIGATION IS STILL ONGOING. A FOLLOW UP REPORT WILL BE SENT UPON COMPLETION OF THE INVESTIGATION.

Description of Event or Problem · 0

IT WAS REPORTED TO INTERVASCULAR THAT WHEN THE DOCTOR OPENED THE PACKAGE, HE FOUND THERE WAS YELLOW DOT ON THE SURFACE OF THE GRAFT. THEN HE USED ANOTHER NEW ONE TO COMPLETE THE SURGERY. COMPLAINT # (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
474608 INTERGARD WOVEN PROSTHESIS, VASCULAR GRAFT, OF 6MM AND GREATER DIAMETER DSY INTERVASCULAR SAS IGW0030-15 25F12 00384401000259

Patients

Seq Age Sex Outcome Treatment
1