EMBOSHIELD NAV 6 22445-31

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 2020-02-24 for EMBOSHIELD NAV 6 22445-31 manufactured by Abbott Vascular.

Event Text Entries

[182326853] The device will not be returned for evaluation, the device was reportedly discarded. Investigation is not yet complete. A follow-up report will be submitted with all additional relevant information.
Patient Sequence No: 1, Text Type: N, H10


[182326874] It was reported that during an atherectomy case in the superficial femoral artery, the barewire of the emboshield nav6 system separated inside the anatomy. A snare was used to retrieve the separated portion as well as the filter of the emboshield nav6. There were no reported adverse patient sequela and there was no reported clinically significant delay in the procedure. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-01741
MDR Report Key9747694
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-02-24
Date of Report2020-02-24
Date of Event2020-01-31
Date Mfgr Received2020-02-03
Date Added to Maude2020-02-24
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 Received2020-02-24
Catalog Number22445-31
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
101. Required No Informationntervention 2020-02-24

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