EMBOSHIELD NAV 6 UNK EMBOSHIELD NAV6

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-02-12 for EMBOSHIELD NAV 6 UNK EMBOSHIELD NAV6 manufactured by Abbott Vascular.

Event Text Entries

[179244193] Unique device identifier (udi#): in the absence of a reported part number, the udi cannot be calculated. The device was not returned for evaluation. The lot history record (lhr) for this product could not be reviewed and a similar complaint query could not be performed because the product was not returned for evaluation and the part and lot numbers were not reported. Based on the reported information, the reported difficulties appear to be due to case circumstances. It is likely that the filter movement was the result of inadvertently pulling the barewire causing the filter to pull out of position. There is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device. The two additional emboshield nav6 embolic protection system (eps) devices referenced are being filed under separate medwatch report numbers.
Patient Sequence No: 1, Text Type: N, H10


[179244194] It was reported that the procedure was performed to treat a lesion in the carotid artery. An unspecified stent was deployed in the carotid artery six months ago and the patient was re-hospitalized on (b)(6) 2020 with in-stent stenosis thought to be thrombosis. An emboshield nav6 embolic protection system (eps) was advanced and the filter was deployed; however, it was realized that a 300centimeter (cm) guide wire was needed in order to use the proposed suction catheter. The filter was removed without issues. A 300cm guide wire was advanced and a second nav6 filter was advanced; however, the guide wire was pulled in accident and the filter moved from its desired location. The filter was removed without issues. The same thing happened with a third nav6 filter and it was removed without issues. A fourth nav6 filter was advanced and the guide wire was locked in place to the sheath; however, the patient experienced groin pain and their blood pressure dropped. The physician started the pace maker that was already in place through the venous access sheath. The nav6 filter was removed without issues and the case was aborted. The patient suffered a mild stroke and was rushed to computed tomography and stroke protocols were put in place. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-01430
MDR Report Key9701860
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-02-12
Date of Report2020-02-12
Date of Event2020-01-23
Date Mfgr Received2020-01-23
Date Added to Maude2020-02-12
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. LINDSEY BELL
Manufacturer Street26531 YNEZ RD.
Manufacturer CityTEMECULA CA 925914628
Manufacturer CountryUS
Manufacturer Postal925914628
Manufacturer Phone9519143996
Manufacturer G1ABBOTT VASCULAR, REG # 2024168
Manufacturer Street26531 YNEZ ROAD
Manufacturer CityTEMECULA CA 925914628
Manufacturer CountryUS
Manufacturer Postal Code925914628
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameEMBOSHIELD NAV 6
Generic NameEMBOLIC PROTECTION SYSTEM
Product CodeNTE
Date Received2020-02-12
Catalog NumberUNK EMBOSHIELD NAV6
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerABBOTT VASCULAR
Manufacturer Address26531 YNEZ RD. TEMECULA CA 925914628 US 925914628


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-12

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