FDA Adverse Event Other Summary report: N

SINGLE LUMEN EMBOLECTOMY CATHETER

MDR report key: 888424 · Received August 2, 2007

Report

Report Number
1220948-2007-00011
Event Type
Other
Date Received
August 2, 2007
Date of Event
March 29, 2007
Report Date
June 4, 2007
Product Code
DXE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE PHYSICIAN USED THE LEMAITRE EMBOLECTOMY CATHETER FOR A VENOUS THROMBECTOMY CASE. THE LEMAITRE EMBOLECTOMY CATHETER IS CONTRAINDICATED FOR USE FOR VENOUS THROMBECTOMY. THE PHYSICIAN DID NOT FOLLOW THE IFU. A COPY OF THE IFU IS BEING SENT WITH THIS REPORT. ADD'L MODEL # 1601-58, ADD'L CATALOG# 1601-58.

Description of Event or Problem · 1

THE PHYSICIAN USED A LEMAITRE EMBOLECTOMY CATHETER FOR A VENOUS THROMBECTOMY CASE. FURTHER DETAILS ON PT INJURY, VESSEL DAMAGE, IS UNK AT THIS TIME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SINGLE LUMEN EMBOLECTOMY CATHETER EMBOLECTOMY CATHETER DXE 1601-48 UNK

Patients

Seq Age Sex Outcome Treatment
1 YR