BEUDAMED
    FDA Adverse Event Death Summary report: N

    SAPPHIRE HELIX SOFT DETACHABLE COIL

    MDR report key: 514430 · Received March 4, 2004

    Report

    Report Number
    2029214-2004-00009
    Event Type
    Death
    Date Received
    March 4, 2004
    Date of Event
    November 22, 2003
    Report Date
    March 4, 2004
    Manufacturer
    MICRO THERAPEUTICS, INC.
    Product Code
    HCG
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CH
    Reporter Occupation
    PHYSICIAN

    Narratives

    Description of Event or Problem · 1

    DURING EMBOLIC COIL DELIVERY, THE COIL BROKE WHILE IN THE CATHETER. A SNARE WAS USED TO RETRIEVE IT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SAPPHIRE HELIX SOFT DETACHABLE COIL EMBOLIC COIL HCG MICRO THERAPEUTICS, INC. * *

    Patients

    Seq Age Sex Outcome Treatment
    1 * Death| R