FDA Adverse Event Injury Summary report: N

INTERLOCKING DETACHABLE COIL

MDR report key: 3150626 · Received June 6, 2013

Report

Report Number
2134265-2013-04002
Event Type
Injury
Date Received
June 6, 2013
Report Date
May 9, 2013
Manufacturer
BOSTON SCIENTIFIC - CORK
Product Code
KRD
PMA / PMN Number
K040342
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

IF IMPLANTED, GIVE DATE: 2003. (B)(4). DEVICE EVALUATED BY MANUFACTURER: IT IS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE, A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. A REVIEW OF THE BATCH HISTORY, HISTORICAL TRENDING, AND SIMILAR COMPLAINT TRENDING REVIEW FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Description of Event or Problem · 1

SAME CASE AS MDR ID: 2134265-2013-04003. IT WAS REPORTED VIA JOURNAL ARTICLE THAT POST AN EMBOLIZATION TREATMENT PROCEDURE, REPERFUSION OCCURRED REQUIRING ADDITIONAL INTERVENTION. THE PATIENT UNDERWENT A FEEDING ARTERY EMBOLIZATION (FAE) FOR TREATMENT OF A PULMONARY ARTERIOVENOUS MALFORMATION (PAVM). A 2.4-F RENEGADE MICROCATHETER WAS ADVANCED COAXIALLY THROUGH A JB1 CATHETER INTO THE VENOUS SAC VIA THE FEEDING ARTERY. FOR TREATMENT, 0.018-INCH IDC (INTERLOCKING DETACHABLE COIL) ABOUT 20% LARGER THAN THE DRAINAGE VEIN WERE USED FIRST, SUBSEQUENTLY FOLLOWED BY 0.018-INCH FIBERED PLATINUM COILS FOR EMBOLIZATION OF THE VENOUS SAC. COMPLETE OCCLUSION OF THE FEEDING ARTERY WAS CONFIRMED WITH PULMONARY ANGIOGRAPHY PERFORMED AFTER EMBOLIZATION. AT THE 68 MONTH FOLLOW UP, REPERFUSION OF THE PAVM WAS CONFIRMED WITH PULMONARY ARTERIOGRAPHY AND BRONCHIAL ARTERIOGRAPHY. THE PATIENTS' REPERFUSED ARTERY WAS NOTED TO BE RECANALIZED. TO MANAGE THE REPERFUSION, THE PATIENT UNDERWENT AN ADDITIONAL FAE. REPERFUSION WAS DEFINED AS "SAC OR DRAINING VEIN BLOOD FLOW REGARDLESS OF THE INFLOW ROUTE AND RECANALIZATION AS SAC BLOOD FLOW FROM THE RECANALIZED ARTERY THAT HAD PREVIOUS EMBOLIZATION WITH COILS."

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
250337 INTERLOCKING DETACHABLE COIL DEVICE, EMBOLIZATION, VASCULAR KRD BOSTON SCIENTIFIC - CORK UNK539

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention