FDA Adverse Event Malfunction Summary report: N

PIPELINE EMBOLIZATION DEVICE

MDR report key: 6439272 · Received March 28, 2017

Report

Report Number
2029214-2017-00238
Event Type
Malfunction
Date Received
March 28, 2017
Date of Event
June 8, 2015
Report Date
March 3, 2017
Manufacturer
COVIDIEN (IRVINE)
Product Code
OUT
PMA / PMN Number
P100018.S004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CITATION: LI-MEI LIN,1 GEOFFREY P COLBY,2 BOWEN JIANG ET. AL INTRA-DIC (DISTAL INTRACRANIAL CATHETER) DEPLOYMENT OF THE PIPELINE EMBOLIZATION DEVICE: A NOVEL RESCUE STRATEGY FOR FAILED DEVICE EXPANSION. J NEUROINTERVENT SURG 2015;0:1¿7. DOI:10.1136/NEURINTSURG-2015-011771 1 THE PIPELINE DEVICE WILL NOT BE RETURNED FOR INVESTIGATION AS IT WAS IMPLANTED IN THE PATIENT; THEREFORE, NO DEFINITIVE CONCLUSION CAN BE DRAWN REGARDING THE CLINICAL OBSERVATION. ADDITIONAL INFORMATION WAS REQUESTED, HOWEVER, NO FURTHER INFORMATION WAS PROVIDED BY THE AUTHOR OF THE ARTICLE. MDRS RELATED TO THIS EVENT: 2029214-2017-00234 2029214-2017-00235 2029214-2017-00236 2029214-2017-00237 2029214-2017-00238 2029214-2017-00239 2029214-2017-00240 2029214-2017-00241 2029214-2017-00242 2029214-2017-00243 2029214-2017-00244.

Description of Event or Problem · 1

MEDTRONIC RECEIVED INFORMATION THAT DURING EMBOLIZATION TREATMENT OF 42MM, FUSIFORM ANEURYSM THAT LOCATED IN ANTERIOR CEREBRAL ARTERY, THE PROXIMAL SEGMENT OF THE PIPELINE EMBOLIZATION DEVICE (PED) WAS NOT FULLY OPENED. IT WAS REPORTED THAT PIPELINE WAS FAILED TO OPEN AND RESULTED IN AN INCOMPLETELY EXPANDED AND STRETCHED THE DEVICE. THE DISTAL INTRACRANIAL CATHETER TECHNIQUE WAS THEN USED TO COMPLETELY OPEN THE PIPELINE. THE PATIENT WAS TREATED WITH FOUR PEDS. NO PATIENT COMPLICATIONS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
223420 PIPELINE EMBOLIZATION DEVICE INTRACRANIAL ANEURYSM FLOW DIVERTER OUT COVIDIEN (IRVINE) FA-71375-30 NOT REPORTED

Patients

Seq Age Sex Outcome Treatment
1 50 YR