FDA Adverse Event Injury Summary report: N

MARATHON MICRO CATHETER

MDR report key: 3121707 · Received May 21, 2013

Report

Report Number
2029214-2013-00483
Event Type
Injury
Date Received
May 21, 2013
Date of Event
February 28, 2013
Report Date
April 26, 2013
Manufacturer
EV3 NEUROVASCULAR
Product Code
DYG
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PL
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE INVOLVED IN THE EVENT WILL NOT BE RETURNED FOR EVALUATION. (B)(4).

Description of Event or Problem · 1

DURING THE ONYX INJECTION, IT WAS REPORTED THAT THE MICROCATHETER RUPTURED 10 CM FROM THE DISTAL END. NO INJURY WAS REPORTED WITH THE PATIENT AS A RESULT OF THE PROCEDURE. SAME EVENT AS MDR# 2029214-2013-00484.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
223888 MARATHON MICRO CATHETER FLOW-DIRECTED MICRO CATHETER DYG EV3 NEUROVASCULAR 105-5055 9685620

Patients

Seq Age Sex Outcome Treatment
1 Disability