SYMMETRY AORTIC CONNECTOR BYPASS SYSTEM ACN-UNKNOWN

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00 report with the FDA on 2007-08-13 for SYMMETRY AORTIC CONNECTOR BYPASS SYSTEM ACN-UNKNOWN manufactured by St. Jude Medical Atg, Inc..

Event Text Entries

[674465] It was reported the patient had a significant history of ischemic cad and previous intervention in 2001, (stenting and angioplasty of the left anterior descending (lad) artery and diagonal-d1, with in-stent restenosis of the angioplasty site). Approx three months later, the patient underwent off-pump cabg x3 with the left internal mammary artery (lima) to lad, and a sjm symmetry connector was utilized for the saphenous vein graft (svg) to the d1. Approx two months later, the patient experienced early svg failure and underwent complex intervention. The svg to the d1 was patient, but severely diseased at the proximal and distal anastomotic areas and was stented. The patient was in stable condition postoperatively.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2135392-2007-00002
MDR Report Key893127
Report Source00
Date Received2007-08-13
Date of Report2007-08-13
Date of Event2001-08-20
Date Mfgr Received2007-08-06
Date Added to Maude2007-08-16
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 ContactDENISE JOHNSON, RN
Manufacturer Street177 EAST COUNTY ROAD B
Manufacturer CityST. PAUL MN 55117
Manufacturer CountryUS
Manufacturer Postal55117
Manufacturer Phone6514832000
Manufacturer G1ST. JUDE MEDICAL ATG, INC.
Manufacturer Street6500 WEDGWOOD ROAD
Manufacturer CityMAPLE GROVE MN 55311
Manufacturer CountryUS
Manufacturer Postal Code55311
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSYMMETRY AORTIC CONNECTOR BYPASS SYSTEM
Generic NameAORTIC CONNECTOR
Product CodeNCA
Date Received2007-08-13
Model NumberACN-UNKNOWN
Catalog NumberACN-UNKNOWN
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrY
Implant FlagY
Date Removed*
Device Sequence No1
Device Event Key873862
ManufacturerST. JUDE MEDICAL ATG, INC.
Manufacturer AddressMAPLE GROVE MN US


Patients

Patient NumberTreatmentOutcomeDate
10 2007-08-13

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