EMBOSHIELD NAV 6 22443-19

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2020-02-13 for EMBOSHIELD NAV 6 22443-19 manufactured by Abbott Vascular.

Event Text Entries

[179280657] Visual, dimensional and functional analysis performed on returned device. A review of the lot history record identified no manufacturing nonconformities issued to the reported lot that would have contributed to this event. The investigation was unable to determine a conclusive cause for the reported difficulty to insert. It may be possible that the filter was pulled into the pod too quickly. Additionally, it may be possible that the difficulty was related to the loading tray; however, without having the tray to examine, this could not be confirmed. Although there is no indication of a product quality issue with respect to manufacture, design or labeling for the returned components, an investigation will be conducted regarding recent incidents of difficulty to insert (load) the emboshield nav6 device. The issue is being addressed per internal operating procedures. Abbott vascular will continue to trend the performance of these devices.
Patient Sequence No: 1, Text Type: N, H10


[179280658] It was reported that during preparation of an emboshield nav6 embolic protection system (eps) the filter could not be inserted into the delivery catheter pod. The delivery catheter pod was wrinkled. The eps was not used and there was no patient involvement. The procedure was successfully completed with a new emboshield nav6 eps. There were no adverse patient effects and no clinically significant delay in the procedure. The returned device analysis identified a vertical tear in the filter membrane proximal to the filter support structure assembly for a length of 1. 5mm. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-01457
MDR Report Key9706445
Report SourceCOMPANY REPRESENTATIVE,DISTRI
Date Received2020-02-13
Date of Report2020-02-13
Date of Event2019-07-22
Date Mfgr Received2020-01-24
Device Manufacturer Date2018-08-29
Date Added to Maude2020-02-13
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 Received2020-02-13
Returned To Mfg2019-12-18
Catalog Number22443-19
Lot Number8082961
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerABBOTT VASCULAR
Manufacturer Address26531 YNEZ RD. TEMECULA CA 925914628 US 925914628


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-13

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