ENDOSURE AAA PRESSURE SENSOR/DELIVERY SYSTEM ADS-1001

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2006-06-22 for ENDOSURE AAA PRESSURE SENSOR/DELIVERY SYSTEM ADS-1001 manufactured by Cardiomems, Inc..

Event Text Entries

[461670] Physician deployed the endosure sensor too high in the aaa sac. The physician could not reach the sensor to pull it into a sheath for removal. While manipulating the sheath, the sensor got caught on the fixation anchors of the gore stent graft, which prevented the stent graft from being positioned properly. The patient was converted to an open repair procedure, the sensor was removed and the pt was discharged without further incident.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3004936110-2006-00002
MDR Report Key728835
Report Source07
Date Received2006-06-22
Date of Report2006-06-22
Date of Event2006-05-24
Date Mfgr Received2006-05-24
Device Manufacturer Date2006-01-01
Date Added to Maude2006-06-28
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 Location0
Manufacturer Street75 FIFTH ST, NW STE 404
Manufacturer CityATLANTA GA 30308
Manufacturer CountryUS
Manufacturer Postal30308
Manufacturer Phone4049206700
Manufacturer G1*
Manufacturer Street*
Manufacturer City*
Manufacturer Country*
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameENDOSURE AAA PRESSURE SENSOR/DELIVERY SYSTEM
Generic NameINTRASAC PRESSURE SENSOR/DELIVERY CATH
Product CodeNQH
Date Received2006-06-22
Model NumberNA
Catalog NumberADS-1001
Lot Number01D015723
ID NumberNA
Device Expiration Date2008-01-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrN
Implant FlagY
Date RemovedV
Device Sequence No1
Device Event Key717118
ManufacturerCARDIOMEMS, INC.
Manufacturer Address* ATLANTA GA * US
Baseline Brand NameENDOSURE AAA PRESSURE SENSOR/DELIVERY SYSTEM
Baseline Generic NameINTRASAC PRESSURE SENSOR/DELIVERY CATHETER
Baseline Model NoNA
Baseline Catalog NoADS-1001
Baseline IDNA


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2006-06-22

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