FDA Adverse Event Death Summary report: N

STENT - VASCULAR RECONSTRUCTION

MDR report key: 8782246 · Received July 11, 2019

Report

Report Number
1226348-2019-00948
Event Type
Death
Date Received
July 11, 2019
Date of Event
August 31, 2017
Report Date
June 20, 2019
Manufacturer
CODMAN AND SHURTLEFF, INC
Product Code
NJE
PMA / PMN Number
UNK
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
KS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). CODMAN AND SHURTLEFF, INC (B)(4). SINCE THE PRODUCT WAS NOT RETURNED FOR ANALYSIS, NO PRODUCT FAILURE ANALYSIS CAN BE CONDUCTED AND NO DETERMINATION OF POSSIBLE CONTRIBUTING FACTORS COULD BE MADE. DEVICE HISTORY RECORD (DHR) REVIEW CANNOT BE CONDUCTED BECAUSE THE NO LOT NUMBER WAS PROVIDED BY THE CUSTOMER.  THIS INFORMATION WAS NOT PROVIDED IN THE REPORTED EVENT OR AVAILABLE AT THE TIME OF REPORT SUBMISSION.

Additional Manufacturer Narrative · 1

THIS IS A CORRECTION OF THE PREVIOUS SUBMISSION REPORT RELATED TO THE LITERATURE ARTICLE ENTITLED ¿FORWARD DEPLOYED COIL EMBOLIZATION WITH MULTIPLE OVERLAPPING STENTS FOR RUPTURED BLOOD BLISTERLIKE ANEURYSMS: TECHNICAL CONSIDERATIONS AND OUTCOMES". THE PRODUCT CODE WAS UPDATED FROM UNKENTERPRISEENC TO UNKENTERPRISEENF.

Description of Event or Problem · 1

THIS COMPLAINT IS FROM A LITERATURE SOURCE. AS REPORTED IN THE LITERATURE PUBLICATION ENTITLED, ¿FORWARD DEPLOYED COIL EMBOLIZATION WITH MULTIPLE OVERLAPPING STENTS FOR RUPTURED BLOOD BLISTERLIKE ANEURYSMS: TECHNICAL CONSIDERATIONS AND OUTCOMES¿. A (B)(6) YEAR-OLD MALE PATIENT WITH BLOOD BLISTER¿LIKE ANEURYSM (BBA) WHO UNDERWENT STENT ASSISTED COIL EMBOLIZATION DEAD FROM SUBARACHNOID HEMORRHAGE (SAH) ON 4 DAYS AFTER TREATMENT. OBJECTIVE: DESCRIBE A SAFE DENSE COIL PACKING TECHNIQUE INTO AND JUST PROXIMAL OF BBAS USING A SEMI-JAILING TECHNIQUE FOR THE TREATMENT OF BBAS OF THE INTERNAL CAROTID ARTERY (ICA) AND REPORT THE LONG-TERM CLINICAL OUTCOMES. SEVENTEEN PATIENTS, 7 MEN AND 10 WOMEN, WERE TREATED BY FORWARD DEPLOYMENT OF COILS UNDER MULTIPLE OVERLAPPING STENTING FROM SEPTEMBER 2008 THROUGH AUGUST 2017. PATIENTS¿ AGES RANGED FROM 27 TO 73 YEARS (MEAN 47.9 ± 11 YEARS).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
573359 STENT - VASCULAR RECONSTRUCTION INTRACRANIAL NEUROVASCULAR STENT NJE CODMAN AND SHURTLEFF, INC

Patients

Seq Age Sex Outcome Treatment
1 58 YR Death| R