FDA Adverse Event Death Summary report: N

PIPELINE EMBOLIZATION DEVICE

MDR report key: 2878397 · Received December 18, 2012

Report

Report Number
2029214-2012-00718
Event Type
Death
Date Received
December 18, 2012
Report Date
November 22, 2012
Manufacturer
EV3 NEUROVASCULAR
Product Code
OUT
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICES INVOLVED IN THE EVENTS WILL NOT BE RETURNED FOR EVALUATION AS THEY WERE IMPLANTED IN THE PATIENTS.(B)(4).

Description of Event or Problem · 1

INFORMATION RECORDED FROM THE ARTICLE AJNR AM J NEURORADIAL 33:1436-46 PUBLISHED IN SEPTEMBER 2012. DURING A RETROSPECTIVE STUDY INVOLVING 251 ANEURYSMS TREATED WITH PEDS IN 191 CONSECUTIVE PATIENTS, ONE PATIENT DIED DUE TO A THROMBUS FORMATION, TWO PATIENTS DEVELOPED IPSILATERAL REMOTE INTRAPARENCHYMAL HEMATOMAS, ONE PATIENT HAD A SUBARACHNOID HEMORRHAGE, ONE PATIENT HAD DYSPHASIA, AND TWENTY-EIGHT PATIENTS WERE PRESENTED WITH A VISION ABNORMALITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PIPELINE EMBOLIZATION DEVICE FLOW DIVERSION OUT EV3 NEUROVASCULAR VARIOUS VARIOUS

Patients

Seq Age Sex Outcome Treatment
1 Death| S