FDA Adverse Event Death Summary report: N

LEVEEN¿ COACCESS¿

MDR report key: 6794791 · Received August 15, 2017

Report

Report Number
2134265-2017-08471
Event Type
Death
Date Received
August 15, 2017
Report Date
August 7, 2017
Manufacturer
BOSTON SCIENTIFIC - COSTA RICA (COYOL)
Product Code
GEI
PMA / PMN Number
K012315
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

BALAGEAS ET AL. (2013). EUROPEAN JOURNAL OF RADIOLOGY. TEN-YEAR EXPERIENCE OF PERCUTANEOUS IMAGE-GUIDED RADIOFREQUENCY ABLATION OF MALIGNANT RENAL TUMORS IN HIGH-RISK PATIENTS. EUR RADIOL, 23, 1925-1932. IT IS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION. A REVIEW OF THE BATCH HISTORY, HISTORICAL TRENDING, AND SIMILAR COMPLAINT TRENDING REVIEW FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. (B)(4).

Description of Event or Problem · 1

REPORTED VIA JOURNAL ARTICLE. IT WAS REPORTED VIA JOURNAL ARTICLE THAT POST RADIOFREQUENCY ABLATION PROCEDURE, ONE PATIENT DIED BECAUSE OF THERMAL INJURY OF THE DUODENUM AND PERFORATION 1 WEEK AFTER THE PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
575929 LEVEEN¿ COACCESS¿ ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES GEI BOSTON SCIENTIFIC - COSTA RICA (COYOL) M001262230

Patients

Seq Age Sex Outcome Treatment
1 Death