inforMED
MalfunctionFKD

GUGLIELMI DETACHABLE COIL

Received Jan 11, 1994 · Event occurred Sep 20, 1993

Report 7537 · MDR key 7537

Device

Generic name

Coil

Model number

350045 (PRODUCT #)

Catalog number

UNKNOWN

Lot number

A12240

Patient

61 YR

Narrative

Description of Event or Problem

THE PATIENT WAS UNDERGOING RIGHT INTERNAL CAROTID ANEURYSM REPAIR. A 5 X 30 MM TRACKER 18 COIL WAS BEING MANIPULATED FOR OPTIMAL POSITIONING WHEN IT WAS IDENTIFIED THAT THE WIRE HAD BROKEN WITHIN THE CATHETER.DEVICE LABELED FOR SINGLE USE. PATIENT MEDICAL STATUS PRIOR TO EVENT: UNKNOWN. THERE WAS NOT MULTIPLE PATIENT INVOLVEMENT.INVALID DATA - ON DEVICE SERVICE/MAINTENANCE. NO DATA - REGARDING DATE LAST SERVICED. SERVICE PROVIDED BY: INVALID DATA. INVALID DATA - SERVICE RECORDS AVAILABILITY.IMMINENT HAZARD TO PUBLIC HEALTH CLAIMED. DEVICE USED AS LABELED/INTENDED.DEVICE WAS EVALUATED AFTER THE EVENT. METHOD OF EVALUATION: ACTUAL DEVICE INVOLVED IN INCIDENT WAS EVALUATED, OTHER. RESULTS OF EVALUATION: OTHER. CONCLUSION: DEVICE FAILURE DIRECTLY CAUSED EVENT. CERTAINTY OF DEVICE AS CAUSE OF OR CONTRIBUTOR TO EVENT: YES. CORRECTIVE ACTIONS: OTHER. THE DEVICE WAS NOT DESTROYED/DISPOSED OF.