TITANIUM GREENFIELD VANA CAVA FILTER N/A 50-301

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 1994-02-04 for TITANIUM GREENFIELD VANA CAVA FILTER N/A 50-301 manufactured by Medi-tech.

Event Text Entries

[9911] Patient underwent a vena cava filter insertion. The initial attempt resulted in premature deployment of the filter within the introducer sheath. This occurred without triggering the release mechanism for the filter. T he procedure was salvaged by withdrawing the introducer wheath and the contained filter to a point where the filter was out of the skin surface. At this point the sheath was transected with a knife blade and a guidewire was inserted through the remaining intravenous sheath and was successfully positioned within the vena cava. The procedure was then started over with the introduction of the sheath and subsequently a new vena cava filter.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number16276
MDR Report Key16276
Date Received1994-02-04
Date of Report1993-11-10
Date of Event1993-10-30
Date Facility Aware1993-11-01
Report Date1993-11-10
Date Reported to Mfgr1993-11-10
Date Added to Maude1994-09-21
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag0
Reporter OccupationRISK MANAGER
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameTITANIUM GREENFIELD VANA CAVA FILTER
Generic NameVENA CAVA FILTER
Product CodeLWT
Date Received1994-02-04
Model NumberN/A
Catalog Number50-301
Lot Number114873
ID NumberN/A
Device Expiration Date1996-04-28
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age*
Implant FlagN
Date RemovedB
Device Sequence No1
Device Event Key16209
ManufacturerMEDI-TECH
Manufacturer Address480 PLEASANT STREET WATERTOWN MA 02172 US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 1994-02-04

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