FDA Adverse Event Malfunction Summary report: N

GREENFIELD VENA CAVA FILTER

MDR report key: 970516 · Received June 9, 2006

Report

Report Number
6000118-2006-00041
Event Type
Malfunction
Date Received
June 9, 2006
Date of Event
May 8, 2006
Report Date
May 11, 2006
Manufacturer
BOSTON SCIENTIFIC
Product Code
DTK
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS NOT BEEN REC'D FOR ANALYSIS AS OF THE DATE OF THIS REPORT.

Description of Event or Problem · 1

SAME CASE AS MFR'S REPORT #6000118-2006-42. IT WAS REPORTED THAT DURING A GREENFIELD VENA CAVA FILTER PLACEMENT PROCEDURE, THE FILTER PARTIALLY DEPLOYED PREMATURELY. THE FILTER WAS RETRIEVED AND THE PHYSICIAN ATTEMPTED TO PLACE ANOTHER GREENFIELD VENA CAVA FILTER. THE SECOND FILTER ALSO DEPLOYED PREMATURELY AND WAS RETRIEVED. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH ANOTHER MFR'S FILTER. THE PT CONDITION IS REPORTED AS 'FINE'.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 GREENFIELD VENA CAVA FILTER VENA CAVA FILTER DTK BOSTON SCIENTIFIC NA 8389567

Patients

Seq Age Sex Outcome Treatment
1 UNKNOWN