FDA Adverse Event Death Summary report: N

ENDURANT

MDR report key: 4933974 · Received July 22, 2015

Report

Report Number
2953200-2015-01107
Event Type
Death
Date Received
July 22, 2015
Date of Event
January 1, 2015
Report Date
June 30, 2015
Manufacturer
MEDTRONIC IRELAND
Product Code
MIH
PMA / PMN Number
P100021
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SF
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4).

Description of Event or Problem · 1

AN ENDURANT STENT GRAFT SYSTEM WAS IMPLANTED FOR THE TREATMENT OF A 5.5CM IN DIAMETER ABDOMINAL AORTIC ANEURYSM. AT THE INDEX PROCEDURE, THE PROXIMAL AORTIC NECK WAS 21-22 MM IN DIAMETER. THE DISTAL AORTA WAS 24 MM IN DIAMETER. THE RIGHT ILIAC ARTERY WAS 12 MM IN DIAMETER AND THE LEFT ILIAC ARTERY WAS 10.9 MM IN DIAMETER. THE RIGHT FEMORAL ARTERY WAS 9.9 MM IN DIAMETER AND THE LEFT FEMORAL ARTERY WAS 8.4 MM IN DIAMETER. IT WAS REPORTED THAT THE PATIENT EXPIRED. THE CAUSE OF DEATH WAS NOT REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
475453 ENDURANT SYSTEM, ENDOVASCULAR GRAFT, AORTIC ANEURYSM TREATMENT MIH MEDTRONIC IRELAND

Patients

Seq Age Sex Outcome Treatment
1 00080 YR Death