GORE VIATORR? TIPS ENDOPROSTHESIS

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-10-02 for GORE VIATORR? TIPS ENDOPROSTHESIS manufactured by W.l. Gore & Associates.

Event Text Entries

[122447221] Device lot number(s) were not provided; therefore, an investigation is unable to be performed and a cause of the reported events cannot be determined. Citation: frakes cm, singh t, sarvepalli s, mccullough a, kapoor b. 30-day readmission rate after transjugular intrahepatic portosystemic shunt. Presented at the 69th annual meeting of the american association for the study of liver diseases (aasld): the liver meeting november 9-13, 2018; san francisco, ca. Gastroenterology 2018;154(6)supplement 1:s-1219. Tu1448.
Patient Sequence No: 1, Text Type: N, H10


[122447222] This information was received through abstract? 30-day readmission rate after transjugular intrahepatic portosystemic shunt" published in gastroenterology in may 2018. The abstract reports the aim of the study was to identify the readmission rate after tips, most common etiology for readmission, and search for potential protective factors association with decreasing readmission rates. Study subjects included 163 patients who underwent primary tips placement with viatorr self-expandable ptfe covered stent grafts from 2011-2016. The abstract reported a 30-day readmission rate of 4% due to incarcerated hernias.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3007284313-2018-00276
MDR Report Key7928042
Date Received2018-10-02
Date of Report2018-09-05
Date of Event2018-05-01
Date Added to Maude2018-10-02
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 ContactMARCI STEWART
Manufacturer Street1500 N. 4TH STREET
Manufacturer CityFLAGSTAFF AZ
Manufacturer Phone9285263030
Manufacturer G1MEDICAL PHOENIX 1 B/P
Manufacturer Street32360 N. NORTH VALLEY PARKWAY
Manufacturer CityPHOENIX AZ 85085
Manufacturer CountryUS
Manufacturer Postal Code85085
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameGORE VIATORR? TIPS ENDOPROSTHESIS
Generic NameSHUNT, PORTOSYSTEMIC, ENDOPROSTHESIS
Product CodeMIR
Date Received2018-10-02
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerW.L. GORE & ASSOCIATES
Manufacturer AddressFLAGSTAFF AZ


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2018-10-02

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