UNK-CNV_NBCA

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,literatur report with the FDA on 2016-04-12 for UNK-CNV_NBCA manufactured by Codman And Shurtleff, Inc.

Event Text Entries

[42418997] This is one of one initial/final mdr reports being submitted for this literature complaint. The literature article is attached to the report. Unknown part number and unknown lot number; all three attempts to obtain product information were unsuccessful, udi is unavailable. Reynolds m. R; arias e. J; chatterjee a. R. ; chicoine m. R. ; cross d. T. (2015, oct 1); acute rupture of a feeding artery aneurysm after embolization of a brain arteriovenous malformation; interventional neuroradiology , vol. 21(5) 613? 619. The product was not returned for analysis and a device history record review cannot be completed because the lot for the product is unknown. The investigation could not be completed; no conclusion could be drawn, as no product was received.
Patient Sequence No: 1, Text Type: N, H10


[42418998] In the literature article "acute rupture of a feeding artery aneurysm after embolization of a brain arteriovenous malformation" by reynolds, matthew r, eric j arias, arindam r chatterjee, michael r chicoine and dewitte t cross iii, published interventional neuroradiology 2015, vol. 21(5) 613 -619, it was reported that a (b)(6) year-old female patient underwent staged treatment of a large arteriovenous malformation (avm) and post operatively suffered rupture of an middle cerebral artery (mca) aneurysm. Per the article: "a (b)(6)-year-old female presented with headache and mild left hemiparesis referable to a 5 cm right frontoparieto- temporal avm with surrounding vasogenic edema. The avm was associated with numerous bilateral feeding artery aneurysms (the largest was a 2 cm right mca bifurcation aneurysm). There was also a large, partially thrombosed venous varix. Staged embolization of the avm was performed. Several hours after the third stage of her embolization, she became obtunded, with a fixed and dilated right pupil. Head computed tomography (ct) showed a large intraparenchymal hemorrhage with midline shift in the right sylvian fissure, remote from the avm nidus. She was taken to surgery for a decompressive craniectomy and hematoma evacuation. The mca aneurysm was confirmed to be the source of hemorrhage and it was clipped. Despite aggressive medical and surgical treatments, the patient died. " the first stage of the treatment involved nbca glue and there were no reported issues after the first intervention. The second intervention was done with a non-codman embolic material and no complications were reported. The third intervention was also done with a non-codman embolic material; however, a large cerebral hemorrhage was noted secondary to rupture of an mca aneurysm with subsequent death noted. The nbca glue cannot be dissociated from the event. At the time of complaint entry no device specific information, i. E. Catalogue/lot number, is available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1226348-2016-00055
MDR Report Key5570106
Report SourceHEALTH PROFESSIONAL,LITERATUR
Date Received2016-04-12
Date of Report2016-03-25
Date of Event2015-10-01
Date Mfgr Received2016-03-25
Date Added to Maude2016-04-12
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKAREN ANIGBO
Manufacturer Street325 PARAMOUNT DRIVE
Manufacturer CityRAYNHAM MA 02767
Manufacturer CountryUS
Manufacturer Postal02767
Manufacturer Phone5088288374
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Generic NameTISSUE ADHESIVE FOR USE IN EMBOLIZATION OF BRAIN ARTERIOVENOUS MALFORMATIONS
Product CodeKGG
Date Received2016-04-12
Catalog NumberUNK-CNV_NBCA
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCODMAN AND SHURTLEFF, INC
Manufacturer Address325 PARAMOUNT DR RAYNHAM MA US


Patients

Patient NumberTreatmentOutcomeDate
101. Death; 2. Hospitalization; 3. Required No Informationntervention 2016-04-12

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