FDA Adverse Event Injury Summary report: N

GUIDANT VIATRAC 14 PLUS PERIPHERAL DILATATION CATHETER

MDR report key: 799138 · Received December 22, 2006

Report

Report Number
3004742046-2006-00549
Event Type
Injury
Date Received
December 22, 2006
Date of Event
November 16, 2006
Report Date
December 5, 2006
Manufacturer
GUIDANT ENDOVASCULAR SOLUTIONS
Product Code
LIT
PMA / PMN Number
k020161
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE RX ACCULINK, PART# 1011344-30, LOT# 6053151 IS INDICATED IN B5 AND D11, AND IS BEING FILED UNDER MFR REPORT NUMBER 3004742046-2006-00548.

Description of Event or Problem · 1

DEVICE MALFUNCTION: NONE. SYMPTOMS/AE: HYPOTENSION, BRADYCARDIA. TIME OF SYMPTOMS/AE: DURING THE PROCEDURE, POST STENT DEPLOYMENT. IT WAS REPORTED THAT DURING A STENTING PROCEDURE OF THE LEFT INTERNAL CAROTID ARTERY, THE PT EXPERIENCED PERSISTENT HYPOTENSION POST STENT DEPLOYMENT AND DILATATION. THE PT RECEIVED BLOOD TRANSFUSIONS AND ALL HER BLOOD PRESSURE MEDICATIONS WERE STOPPED. ADDITIONALLY, THE PT EXPERIENCED BRADYCARDIA POST DILATATION, WHICH WAS MEDICALLY MANAGED. SUBSEQUENTLY, BLOOD PRESSURE CAME UP AND THE PT WAS DISCHARGED TO HOME IN 2006 IN STABLE CONDITION. NO ADD'L INFO IS AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GUIDANT VIATRAC 14 PLUS PERIPHERAL DILATATION CATHETER 74LIT LIT GUIDANT ENDOVASCULAR SOLUTIONS NA UNK

Patients

Seq Age Sex Outcome Treatment
1 67 YR Required Intervention GUIDE CATHETER: MP 1 8FR| OTHER: RX ACCUNET| STENT: RX ACCULINK| DILATATION CATHETER: FR4 6FR| SHEATH: SUPER SHEATH 8FR| GUIDE WIRE: J WIRES .035 145CM FIXED CORE (X2)