FDA Adverse Event Malfunction Summary report: N

ENDURANT

MDR report key: 4251196 · Received November 14, 2014

Report

Report Number
2953200-2014-02404
Event Type
Malfunction
Date Received
November 14, 2014
Date of Event
October 3, 2014
Report Date
October 22, 2014
Manufacturer
MEDTRONIC IRELAND
Product Code
MIH
PMA / PMN Number
P100021
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PO
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

AN ENDURANT II STENT GRAFT SYSTEM WAS IMPLANTED IN A PATIENT FOR THE ENDOVASCULAR TREATMENT OF A 55 MM DIAMETER ABDOMINAL AORTIC ANEURYSM. IT WAS REPORTED THAT RECENT IMAGING ON A CT WITH CONTRAST SHOWED THERE WAS AN UNKNOWN TYPE OF ENDOLEAK AND THE ANEURYSM WAS 49 MM IN DIAMETER. THE ENDOLEAK WAS LEFT UNCORRECTED. NO FURTHER INFORMATION WAS PROVIDED. NO CLINICAL SEQUELAE WERE REPORTED AND THE PATIENT IS FINE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
736165 ENDURANT SYSTEM, ENDOVASCULAR GRAFT, AORTIC ANEURYSM TREATMENT MIH MEDTRONIC IRELAND V00495366

Patients

Seq Age Sex Outcome Treatment
1 00071 YR