YASARGIL TI PERM MINI-CLIPLGT-CVD5.2MM FT726T

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2018-07-03 for YASARGIL TI PERM MINI-CLIPLGT-CVD5.2MM FT726T manufactured by Aesculap Ag.

Event Text Entries

[113177020] (b)(4). Manufacturing site evaluation: five aneurysm clips were returned for investigation. The clips were scratched and deformed. Especially the geometry of the jaws are no longer even. The investigation was carried out visually using a digital microscope. At all provided products several deviations on the surface, the geometry and the symmetry can be found. These deviations were most likely caused by improper handling during application most likely repeatedly open and close clip. The device quality and manufacturing history records have been checked for all available lot numbers. The device history fie has been checked and found to be according to the specification valid at the time of production. No similar incidents have been filed with products from these batches. Based on the information available as well as a result of investigation the root cause of the failure is most probably related to an insufficient usage. A capa is not necessary.
Patient Sequence No: 1, Text Type: N, H10


[113177021] Country of complaint: (b)(6). It was reported that when using the clip, the clip does not close completely. When placing the semi-circular clip on the neck of the aneurysm, this opened the middle cerebral artery that was with a temporary clip, the 5mm semi-curved clips opened, leaving the aneurysm permeable. When placing the clip on the basis of the aneurysm, there is no proper closing and it is easily detached from its position so it does not meet the desired objective (it does not work) all med watch submissions related to this report are: 9610612-2018-00266, 9610612-2018-00267, 9610612-2018-00268, 9610612-2018-00269, 9610612-2018-00270.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9610612-2018-00269
MDR Report Key7660855
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2018-07-03
Date of Report2018-07-03
Date of Event2018-06-04
Date Facility Aware2018-06-12
Date Mfgr Received2018-06-05
Device Manufacturer Date2016-10-18
Date Added to Maude2018-07-03
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 ContactMS. NICOLE BROYLES
Manufacturer Street615 LAMBERT POINTE DRIVE
Manufacturer CityHAZELWOOD MO 63042
Manufacturer CountryUS
Manufacturer Postal63042
Manufacturer G1AESCULAP AG
Manufacturer StreetPO BOX 40
Manufacturer CityTUTTLINGEN, 78501
Manufacturer CountryGM
Manufacturer Postal Code78501
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameYASARGIL TI PERM MINI-CLIPLGT-CVD5.2MM
Generic NameYASARGIL TITANIUM ANEURYSM CLIPS PE
Product CodeHCH
Date Received2018-07-03
Returned To Mfg2018-06-21
Model NumberFT726T
Catalog NumberFT726T
Lot Number52263473
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Age1 YR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerAESCULAP AG
Manufacturer AddressPO BOX 40 TUTTLINGEN, 78501 GM 78501


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2018-07-03

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