MARKSMAN FA-55150-1030

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2020-02-28 for MARKSMAN FA-55150-1030 manufactured by Micro Therapeutics, Inc. Dba Ev3.

Event Text Entries

[181768238] As the device was received in a condition was contradictory to the complaint description. The marksman catheter found separated. This condition was not reported at time of the event. As received, the medtronic flow diversion was returned within the marksman catheter. The flow diversion pushwire was found protruding from within the marksman hub. No damages were found with the marksman hub. The marksman catheter body was found accordioned and separated from the proximal end of the hub. In addition, the marksman catheter body was found accordioned from the distal tip. During evaluation, the marksman catheter was dissected (cut) to remove the stuck flow diversion embolization device. Based on the returned device device analysis and reported information, it appears that there was high force used. It is likely this damage occurred when the customer attempted to advance flow diversion through the marksman catheter against resistance subsequently causing the catheter to become separated. Based on the investigation conducted resistance can occur during tracking, deployment and re-sheathing of the device in distal and tortuous anatomies. In addition, resistance can occur due to patient vessel tortuosity, failure to maintain a continuous flush, or embolization device is pulled back/torqued during delivery. The vessel anatomy was normal in tortuosity and a continuous flush was maintained. Therefore, the cause could not be determined. If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10


[181768239] Medtronic received information that resistance was encountered while pushing the medtronic flow diversion through the distal section of the marksman microcatheter, and the flow diversion could not be released normally. The both catheter and flow diversion removed from the patient. The patient underwent embolization treatment with flow diversion for an unruptured, saccular aneurysm located at the right ophthalmic artery segment with a max diameter of 7. 17mm and a neck diameter of 5. 75mm. The distal landing zone was 4. 16mm and the proximal landing zone was 4. 24mm. It was noted the vessel tortuosity was normal. There were no reports of patient injury in association with this event. Evaluation of the returned device found that the marksman catheter was separated from the proximal end of the hub.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2029214-2020-00174
MDR Report Key9769631
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-02-28
Date of Report2020-02-28
Date of Event2019-11-12
Date Mfgr Received2020-02-18
Date Added to Maude2020-02-28
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 ContactMGR. KATCHA TAYLOR
Manufacturer Street9775 TOLEDO WAY
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal92618
Manufacturer Phone9496801345
Manufacturer G1MICRO THERAPEUTICS, INC. DBA EV3
Manufacturer Street9775 TOLEDO WAY
Manufacturer CityIRVINE CA 92618
Manufacturer CountryUS
Manufacturer Postal Code92618
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMARKSMAN
Generic NameCATHETER, CONTINUOUS FLUSH
Product CodeKRA
Date Received2020-02-28
Returned To Mfg2019-12-12
Model NumberFA-55150-1030
Lot Number217757006
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerMICRO THERAPEUTICS, INC. DBA EV3
Manufacturer Address9775 TOLEDO WAY IRVINE CA 92618 US 92618


Patients

Patient NumberTreatmentOutcomeDate
10 2020-02-28

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