MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2017-08-14 for SPECTRANETICS CORONARY LASER ATHERECTOMY CATHETER 110-004 manufactured by Spectranetics.
[82586940]
Patient weight is not available from the facility.
Patient Sequence No: 1, Text Type: N, H10
[82586941]
It was reported that during an in-stent restenosis in the patient's lad, a perforation occurred. Reportedly, multiple passes had been completed with the elca device, until a perforation of lad was identified. A stent and graft-master were utilized which brought the patient's blood pressure back up. The patient fully recovered and outcome was good.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1721279-2017-00164 |
| MDR Report Key | 6791319 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2017-08-14 |
| Date of Report | 2017-07-21 |
| Date of Event | 2017-07-21 |
| Date Mfgr Received | 2017-07-21 |
| Device Manufacturer Date | 2017-06-13 |
| Date Added to Maude | 2017-08-14 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. NICK MCNABB |
| Manufacturer Street | 9965 FEDERAL DRIVE |
| Manufacturer City | COLORADO SPRINGS CO 80921 |
| Manufacturer Country | US |
| Manufacturer Postal | 80921 |
| Manufacturer Phone | 719447-257 |
| Manufacturer G1 | SPECTRANETICS |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | SPECTRANETICS CORONARY LASER ATHERECTOMY CATHETER |
| Generic Name | ELCA |
| Product Code | LPC |
| Date Received | 2017-08-14 |
| Model Number | 110-004 |
| Catalog Number | 110-004 |
| Lot Number | FHH17F13A |
| ID Number | NI |
| Device Expiration Date | 2019-06-19 |
| Operator | PHYSICIAN |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | SPECTRANETICS |
| Manufacturer Address | 9965 FEDERAL DRIVE COLORADO SPRINGS CO 80921 US 80921 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Life Threatening; 2. Required No Informationntervention | 2017-08-14 |