inforMED
MalfunctionNQH

CARDIOMEMS ENDOSURE DELIVERY SYSTEM

Received Jun 14, 2007 · Event occurred May 18, 2007

Report 3004936110-2007-00006 · MDR key 865886

Device

Generic name

Intravascular Pressure Sensor

Manufacturer

Cardiomems, Inc.

Catalog number

ADS-1001

Product problems

  • Disengaged
  • Kinked
  • Device, removal of (non-implant)

Patient

74 YR

  • Dural Tear
  • Surgical procedure
  • Foreign body, removal of

Narrative

Description of Event or Problem

THE DELIVERY SYSTEM WAS REMOVED FROM THE PATIENT DUE TO SEVERE KINKING OF THE TETHER BY THE PHYSICIAN. AFTER REMOVING THE DELIVERY SYSTEM, IT WAS NOTED THAT THE SENSOR HAD BEEN RELEASED AND WAS LEFT IN THE ILIAC ARTERY. THE SENSOR WAS REMOVED WHICH CREATED A SMALL TEAR IN THE ILIAC. THE TEAR AS REPAIRED AND THE PATIENT WAS DISCHARGED WITH NO ISSUES.