FDA Adverse Event Injury Summary report: N

ZENITH TX2 TAA ENDOVASCULAR GRAFT TAA ANCILLARY COMPONET DISTAL EXTENSION

MDR report key: 6025396 · Received October 13, 2016

Report

Report Number
3002808486-2016-01228
Event Type
Injury
Date Received
October 13, 2016
Date of Event
September 20, 2016
Report Date
September 29, 2016
Manufacturer
WILLIAM COOK EUROPE
Product Code
MIH
UDI-DI
10827002443454
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

EXEMPTION NUMBER E2016032. (B)(4). SUMMARY OF INVESTIGATIONAL FINDINGS: THIS PR WAS RE-OPENED DUE TO ADDITIONAL INFORMATION PROVIDED IN THE DESCRIPTION OF EVENT: THE ADDITIONAL INFORMATION DOES NOT CHANGE THE PREVIOUS CONCLUSION OR RISK ASSESSMENT OF THE COMPLAINT INVESTIGATION. IT IS STILL NOT POSSIBLE TO DETERMINE THE ROOT CAUSE OF THE REPORTED EVENT, AS NO IMAGING IS AVAILABLE. BASED ON THE INFORMATION IT WAS NOT POSSIBLE TO DETERMINE THE ROOT CAUSE OF THE REPORTED EVENT, AS NO IMAGING WAS AVAILABLE. AS PER IFU, ENDOLEAK IS A KNOWN POTENTIAL EFFECT AND CAN, AMONG OTHERS, BE DUE TO: PROXIMAL AND DISTAL FIXATION SITES WITH A LENGTH OF LESS THAN 20 MM. CIRCUMFERENTIAL THROMBUS AND/OR CALCIFICATION AT THE FIXATION SITES. LESS THAN THE REQUIRED 2 STENTS (~50 MM) OF OVERLAP BETWEEN DEVICES. SIZING OUTSIDE THE SIZING CHART. NONE OF THESE FACTORS CAN BE RULED OUT WITHOUT IMAGING. PATIENTS WITH SPECIFIC CLINICAL FINDINGS, INCLUDING ENDOLEAKS, SHOULD RECEIVE ENHANCED FOLLOWUP. NO EVIDENCE TO SUGGEST THAT THE DEVICE WAS NOT MANUFACTURED ACCORDING TO SPECIFICATION. COOK MEDICAL WILL CONTINUE TO MONITOR FOR SIMILAR EVENTS.

Additional Manufacturer Narrative · 1

(B)(4). DEVICE SIMILAR TO DEVICE UNDER 510(K) P070016. B)(4). INVESTIGATION IS STILL IN PROGRESS.

Additional Manufacturer Narrative · 1

(B)(4). DEVICE SIMILAR TO DEVICE UNDER 510(K) P070016. (B)(4). SUMMARY OF INVESTIGATIONAL FINDINGS: BASED ON THE INFORMATION IT WAS NOT POSSIBLE TO DETERMINE THE ROOT CAUSE OF THE REPORTED EVENT, AS NO IMAGES WAS AVAILABLE. AS PER IFU, ENDOLEAK IS A KNOWN POTENTIAL EFFECT AND CAN, AMONG OTHERS, BE DUE TO: PROXIMAL AND DISTAL FIXATION SITES WITH A LENGTH OF LESS THAN 20 MM; CIRCUMFERENTIAL THROMBUS AND/OR CALCIFICATION AT THE FIXATION SITES; LESS THAN THE REQUIRED 2 STENTS (~50 MM) OF OVERLAP BETWEEN DEVICES; SIZING OUTSIDE THE SIZING CHART. NONE OF THESE FACTORS CAN BE RULED OUT WITHOUT PROVIDED IMAGES. PATIENTS WITH SPECIFIC CLINICAL FINDINGS, INCLUDING ENDOLEAKS, SHOULD RECEIVE ENHANCED FOLLOW UP. NO EVIDENCE TO SUGGEST THAT THIS DEVICE WAS NOT MANUFACTURED ACCORDING TO SPECIFICATIONS. COOK MEDICAL WILL CONTINUE TO MONITOR FOR SIMILAR EVENTS.

Description of Event or Problem · 1

ADDITIONAL INFORMATION WITH CORRECTION 06OCT2017: (B)(6) 2016: 1YEAR FOLLOW UP CT ANGIO CONFIRMED RE-ENTRY AT THE CELIAC ARTERY.

Description of Event or Problem · 1

DESCRIPTION OF EVENT ACCORDING TO STUDY: ON (B)(6) 2015: A FEMALE PATIENT UNDERWENT TEVAR WITH ZTEG-2PT-34-197-PF-D/ E3334269 IN THE PROXIMAL SITE AND ESBE-30-80-T-PF-D/ E3302841 IN THE DISTAL SITE. ON (B)(6) 2016: 1 YEAR F/U CT ANGIO CONFIRMED DISTAL TYPE I ENTRYFLOW. PATIENT OUTCOME: NO PROBLEMATIC SYMPTOMS DUE TO THIS EVENT HAS BEEN REPORTED.

Description of Event or Problem · 1

DESCRIPTION OF EVENT ACCORDING TO STUDY: ON (B)(6) 2015: A FEMALE PATIENT UNDERWENT TEVAR WITH ZTEG-2PT-34-197-PF-D/ E3334269 IN THE PROXIMAL SITE AND ESBE-30-80-T-PF-D/ E3302841 IN THE DISTAL SITE. ON (B)(6) 2016: 1YEAR F/U CT ANGIO CONFIRMED DISTAL TYPE I ENTRYFLOW. PATIENT OUTCOME: NO PROBLEMATIC SYMPTOMS DUE TO THIS EVENT HAS BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
676520 ZENITH TX2 TAA ENDOVASCULAR GRAFT TAA ANCILLARY COMPONET DISTAL EXTENSION MIH SYSTEM, ENDOVASCULAR GRAFT, AORTIC ANEURYSM TREATMENT MIH WILLIAM COOK EUROPE 10827002443454

Patients

Seq Age Sex Outcome Treatment
1 69 YR Life Threatening