OMNILINK ELITE 1012631-19

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 2020-03-13 for OMNILINK ELITE 1012631-19 manufactured by Abbott Vascular.

Event Text Entries

[183482607] The device was not returned for evaluation. A review of the lot history record identified no manufacturing nonconformities issued to the reported lot that would have contributed to this event. Additionally, a review of the complaint history identified no indication of a lot specific product issue. Based on the information provided, the reported difficulties appear to be due to case circumstances. The failure to advance and stent dislodgment were due to interactions with the anatomy. There is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
Patient Sequence No: 1, Text Type: N, H10


[183482608] It was reported that the procedure was performed to treat a heavily calcified non-tortuous right subclavian artery. The 8. 0x19mm omnilink elite stent delivery catheter failed to cross due to the anatomy and during removal of the device, the stent dislodged outside of the patient while at the hub of the unspecified sheath. The procedure was successfully completed with a 8x17mm non-abbott stent. There were no adverse patient effects and no clinically significant delay in the procedure. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-02417
MDR Report Key9831834
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-13
Date of Report2020-03-13
Date of Event2020-02-26
Date Mfgr Received2020-02-26
Device Manufacturer Date2019-06-21
Date Added to Maude2020-03-13
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 # 3005718570 (P099)
Manufacturer StreetCASHEL ROAD
Manufacturer CityCLONMEL TIPPERARY
Manufacturer CountryEI
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOMNILINK ELITE
Generic NamePERIPHERAL STENT DELIVERY SYSTEM
Product CodeNIO
Date Received2020-03-13
Model Number1012631-19
Catalog Number1012631-19
Lot Number9062141
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 2020-03-13

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