ENDO ANCHOR SYSTEM - HELI-FX AAA SA-85

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 2020-03-18 for ENDO ANCHOR SYSTEM - HELI-FX AAA SA-85 manufactured by Medtronic Ireland.

Event Text Entries

[184266669] If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[184266670] An endurant iis along with heli-fx endoanchors were implanted in the endovascular treatment of a unknown size abdominal aortic aneurysm on the (b)(6) 2017. It was reported that approximately 2 years and 8 months post index procedure that a possible type ia endoleak was identified along with a persistent type ii on ultrasound and confirmed 5 days later. On an unknown date this device was explanted due to the presence of a persistent endoleak and the further progression of the patient's pararenal disease. As per the physician the cause of the event is due to the persistent endoleak and pararenal disease progression. No additional clinical sequalae were provided and patient is fine.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9612164-2020-01203
MDR Report Key9847283
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-18
Date of Report2020-03-18
Date Mfgr Received2020-02-18
Date Added to Maude2020-03-18
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 ContactALISON SWEENEY
Manufacturer StreetPARKMORE BUSINESS PARK WEST
Manufacturer CityGALWAY
Manufacturer CountryIE
Manufacturer Phone091708096
Manufacturer G1MEDTRONIC IRELAND
Manufacturer StreetPARKMORE BUSINESS PARK WEST
Manufacturer CityGALWAY
Manufacturer CountryIE
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameENDO ANCHOR SYSTEM - HELI-FX AAA
Generic NameENDOVASCULAR SUTURING SYSTEM
Product CodeOTD
Date Received2020-03-18
Model NumberSA-85
Catalog NumberSA-85
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC IRELAND
Manufacturer AddressPARKMORE BUSINESS PARK WEST GALWAY IE


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2020-03-18

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