FDA Adverse Event Other Summary report: N

BRIDGE ASSURANT BILIARY STENT SYSTEM

MDR report key: 568834 · Received January 28, 2005

Report

Report Number
2953200-2005-01019
Event Type
Other
Date Received
January 28, 2005
Date of Event
January 1, 2004
Report Date
December 30, 2004
Manufacturer
MEDTRONIC VASCULAR
Product Code
FGE
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KS, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

AN 8 MM DIAMETER X 4.0 CM LENGTH BRIDGE ASSURANT BILIARY STENT WAS IMPLANTED INTO A PT FOR THE TREATMENT OF AN UNKNOWN LESION. VESSEL MORPHOLOGY IS UNKNOWN. IT WAS REPORTED THAT AFTER THE STENT WAS DEPLOYED, THE BALLOON WAS DIFFICULT TO DEFLATE. SEVERAL ATTEMPTS TO OBTAIN ADDITIONAL INFORMATION WERE MADE; HOWEVER, THE USER FACILITY DID NOT PROVIDE ADDITIONAL INFORMATION. MEDTRONIC RECEIVED THE STENT DELIVERY SYSTEM IN 2005 AND ITS INVESTIGATION IS PENDING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BRIDGE ASSURANT BILIARY STENT SYSTEM PERIPHERAL STENT SYSTEM FGE MEDTRONIC VASCULAR NA 3A16E03

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN Other