PENUMBRA SYSTEM JET7 REPERFUSION CATHETER 5MAXJET7KIT-B 5MAXJET7KIT

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 2020-03-17 for PENUMBRA SYSTEM JET7 REPERFUSION CATHETER 5MAXJET7KIT-B 5MAXJET7KIT manufactured by Penumbra, Inc..

Event Text Entries

[183915488] This device is available for return. A follow up mdr will be submitted upon completion of the device investigation. Please note that this complaint was submitted to the fda by the user facility with the following reference number: mw5093205.
Patient Sequence No: 1, Text Type: N, H10


[183915489] The patient was undergoing a thrombectomy procedure in the middle cerebral artery using a penumbra system jet 7 reperfusion catheter (jet7) and neuron max 6f 088 long sheath (neuron max). During the procedure, the physician made an unknown number of passes in the target vessel using the jet7 and neuron max. While removing the jet7 out of the neuron max, the jet7 became damaged and began to unravel inside the neuron max. The jet7 was carefully removed from the neuron max. It is unknown how the procedure was completed. There was no report of an adverse effect to the patient. No additional information is available.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005168196-2020-00372
MDR Report Key9845743
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-17
Date of Report2020-02-19
Date of Event2020-02-19
Report Date2005-01-01
Date Reported to FDA2005-01-01
Date Reported to Mfgr2005-01-10
Date Mfgr Received2020-02-19
Date Added to Maude2020-03-17
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. VERONICA FARRIS
Manufacturer StreetONE PENUMBRA PLACE
Manufacturer CityALAMEDA CA 94502
Manufacturer CountryUS
Manufacturer Postal94502
Manufacturer Phone5107483200
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Sequence Number: 1

Brand NamePENUMBRA SYSTEM JET7 REPERFUSION CATHETER
Generic NameNRY
Product CodeNRY
Date Received2020-03-17
Model Number5MAXJET7KIT-B
Catalog Number5MAXJET7KIT
Lot NumberF94084
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Sequence No1
Device Event Key0
ManufacturerPENUMBRA, INC.
Manufacturer AddressONE PENUMBRA PLACE ALAMEDA CA 94502 US 94502

Device Sequence Number: 101

Product Code---
Date Received2020-03-17
Device Sequence No101
Device Event Key0


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-17

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