FDA Adverse Event Injury Summary report: N

.016 GLIDEWIRE GOLD

MDR report key: 6243 · Received July 27, 1993

Report

Report Number
1219544-1993-00031
Event Type
Injury
Date Received
July 27, 1993
Report Date
June 30, 1993
Manufacturer
TERUMO
Product Code
MKI
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
TX, US
Reporter Occupation
UNKNOWN

Narratives

Description of Event or Problem · 1

THE DISTRIBUTOR BECAME AWARE ON 6/24/93 OF AN INCIDENT THAT OCCURRED IN AUGUST OF 1992 INVOLVING A GLIDEWIRE GOLD. AN IDENTIFIED MIDDLE CEREBRAL FEEDER AVM AWAS TO BE EMBOLIZED WITH POLYVINYL ALCHOL PRE SURGICAL EXCISION. AFTER ENTERING THE MIDDLE CEREBRAL ARTERY A TEST INJECTION OF AMYTAL EFFECTED THE EXPECTED RIGHT SIDED PARALYSIS. HOWEVER, THE PARALYSIS DID NOT ABATE AND FURTHER INVESTIGATION EVIDENCED A VERY SMALL MIDDLE CEREBRAL ARTERIAL BLEED. IT IS BELIEVED THE GLIDEWIRE PERFORATED THE ARTERY. SEVERAL DAYS LATER THE PATIENT UNDERWENT A SUCCESSFUL UNEVENTFUL SURGICAL EXCISION OF THE AVM. A RESIDUAL OF FOOT DROP WAS THE POST OPERATIVE SEQUELAE. THIS IS BELIEVED TO BE A RESULT OF THE SURGERY AND NOT THE GLIDEWIRE INCIDENTDEVICE LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: UNKNOWN. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY. NO IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE NOT USED AS LABELED/INDENDED.INVALID DATA - REGARDING EVALUATION BY USER AFTER EVENT. METHOD OF EVALUATION: INVALID DATA. RESULTS OF EVALUATION: INVALID DATA. CONCLUSION: INVALID DATA. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: UNKNOWN (CANNOT DETERMINE). CORRECTIVE ACTIONS: DEVICE DISCARDED. THE DEVICE WAS DESTROYED/DISPOSED OF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 .016 GLIDEWIRE GOLD GUIDEWIRE MKI TERUMO UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 UNK Required Intervention