ENDO ANCHOR SYSTEM - HELI-FX AAA SA-85

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 2020-02-03 for ENDO ANCHOR SYSTEM - HELI-FX AAA SA-85 manufactured by Medtronic Ireland.

Event Text Entries

[177541832] Other relevant device(s) are: product id: sg-64, serial/lot #: (b)(4), ubd: 08-jul-2020, udi#: (b)(4). If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[177541833] An endurant iis stent graft system was in a patient for the endovascular treatment of a 24mm abdominal aortic aneurysm. Eight heli-fx endoanchors were also deployed during the procedure due to concern for late failure. It was reported that the patient presented with generalised abdominal pain in the post-operative period with associated diarrhoea. Ct angiogram also showed generalised thickening of the wall of the descending colon with transient ischemia. It was reported that the patient recovered with treatment the day after the index procedure. The event was assessed by the investigator to be related to the index procedure. No additional clinical sequelae were reported, and the patient is fine.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9612164-2020-00517
MDR Report Key9658943
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-02-03
Date of Report2020-02-03
Date of Event2019-05-29
Date Mfgr Received2020-01-29
Device Manufacturer Date2019-02-13
Date Added to Maude2020-02-03
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 ContactALISON SWEENEY
Manufacturer StreetPARKMORE BUSINESS PARK WEST
Manufacturer CityGALWAY
Manufacturer CountryIE
Manufacturer Phone091708096
Manufacturer G1MEDTRONIC IRELAND
Manufacturer StreetPARKMORE BUSINESS PARK WEST
Manufacturer CityGALWAY
Manufacturer CountryIE
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameENDO ANCHOR SYSTEM - HELI-FX AAA
Generic NameENDOVASCULAR SUTURING SYSTEM
Product CodeOTD
Date Received2020-02-03
Model NumberSA-85
Catalog NumberSA-85
Lot Number0009590597
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC IRELAND
Manufacturer AddressPARKMORE BUSINESS PARK WEST GALWAY IE


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-02-03

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