FDA Adverse Event Injury Summary report: N

RX ACCULINK CAROTID STENT SYSTEM

MDR report key: 927773 · Received October 15, 2007

Report

Report Number
3004742046-2007-00317
Event Type
Injury
Date Received
October 15, 2007
Date of Event
September 26, 2007
Report Date
September 26, 2007
Manufacturer
ABBOTT VASCULAR-VASCULAR SOLUTIONS
Product Code
NIM
PMA / PMN Number
P040012
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DURING PROCESSING OF THIS COMPLAINT, ATTEMPTS WERE MADE TO OBTAIN COMPLETE EVENT, PT, AND DEVICE INFORMATION. THE DEVICE REMAINS IN THE PT. THE LOT NUMBER WAS PROVIDED. A REVIEW OF THE DEVICE HISTORY RECORD DID NOT PRODUCE ANY FINDINGS RELEVANT TO THIS REPORT. THE RX ACCUNET PART # 1011649-55, LOT # 7083051 AND RX ACCULINK PART # 1011342-40, LOT #5110751, ARE BEING FILED UNDER SEPARATE MEDWATCH REPORTS.

Description of Event or Problem · 1

PRODUCT MALFUNCTION: NONE. SYMPTOMS/AE: STROKE. TIME OF AE: DURING THE PROCEDURE. IT WAS REPORTED THAT DURING A LEFT COMMON CAROTID ARTERY STENTING PROCEDURE USING TWO RX ACCULINK STENTS, THE PT SUFFERED A STROKE. DURING POST STENT DILATATION, THE PT BECAME HEMIPLEGIC ON THE RIGHT SIDE WITH DECREASED SPEECH. THE ANGIOGRAM SHOWED A PATENT STENT WITH PRESERVED INTRACRANIAL CIRCULATION. THE PT WAS TAKEN FOR A CT SCAN WHICH SHOWED NO ACUTE BLEED. THE NEUROLOGIST FELT IT WAS AN ISCHEMIC EVENT. THE PT HAD CHRONIC MICROVASCULAR SMALL VESSEL DISEASE AND DID NOT TOLERATE THE BALLOON INFLATIONS. THE PT WAS APHASIC, DYSPHAGIC AND WAS HAVING DIFFICULTY KEEPING HIS AIRWAY CLEAR. ONE DAY POST PROCEDURE, THE PT WAS DISCHARGED TO A NEURO INTENSIVE CARE UNIT. EIGHT DAYS POST PROCEDURE, HE WAS TRANSFERRED TO A STEPDOWN UNIT. THE PT CONTINUES TO HAVE DIFFICULTY KEEPING HIS AIRWAY CLEAR, IS ON BIPAP AND IS BEING SUCTIONED FREQUENTLY. A PEG TUBE WAS PLACED AND FEEDINGS WERE STARTED. IF THE PT CAN MAINTAIN HIS RESPIRATORY STATUS, HE WILL BE TRANSFERRED TO A REHABILITATION FACILITY. ALTHOUGH REQUESTED, THERE IS NO ADDITIONAL INFORMATION AVAILABLE. STUDY EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RX ACCULINK CAROTID STENT SYSTEM NIM ABBOTT VASCULAR-VASCULAR SOLUTIONS NA 5110751

Patients

Seq Age Sex Outcome Treatment
1 YR Hospitalization| R| S POST DIL: BOSTON SCIENTIFIC STERLING 7.0X3.0X135| RX ACCUNET PART # 1011649-55| HEPARIN| RX ACCULINK PART # 1011342-40