MalfunctionPOL
MEDTRONIC SOLITAIRE X REVASCULARIZATION DEVICE 4MM X 40MM /STENT
Received Jan 30, 2020 · Event occurred Jan 20, 2020
Report MW5092657 · MDR key 9653617
Device
Generic name
Neurovascular Mechanical Thrombectomy Device For Acute Ischemic Stroke Treatment
Manufacturer
Micro Therapeutic Inc/ Medtronic Inc.Lot number
A861719
Product problems
- Material Separation
Patient
88 YR
- No Known Impact Or Consequence To Patient
- No Known Impact Or Consequence To Patient
Narrative
Description of Event or Problem
SOLITAIRE STENT RETRIEVER BEING USED FOR A MECHANICAL THROMBECTOMY PROCEDURE BECAME SEPARATED FROM ITS DELIVERY WIRE. IT WAS DEPLOYED IN THE PT'S CAROTID ARTERY. SOLITAIR DELIVERY WIRE DETACHED FROM STENT RETRIEVER DEVICE AT CAROTID SIPHON (LOCATION OF INTRACRANIAL STENOSIS) DURING RETRIEVAL; STENT LEFT IN PLACE AT LEVEL OF STENOSIS. DELIVERY WIRE FRAGMENT RETRIEVED WITH SNARE. FDA SAFETY REPORT ID# (B)(4).