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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDOS INTERNATIONAL SARL ENTERPRISE2 4MMX23MM; INTRACRANIAL NEUROVASCULAR STENT

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MEDOS INTERNATIONAL SARL ENTERPRISE2 4MMX23MM; INTRACRANIAL NEUROVASCULAR STENT Back to Search Results
Catalog Number ENCR402312
Device Problem Activation Failure (3270)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 11/09/2023
Event Type  malfunction  
Manufacturer Narrative
Manufacturer¿s ref.No: (b)(4).Information regarding patient identifier, date of birth, age, gender, weight, race, and ethnicity were not provided.Section e.1: the initial reporter phone: (b)(6).The initial reporter email address was not available / reported.Based on complaint information, the device is not available to be returned for analysis.(b)(6) medical performed a review of the device history records relative to the manufacturing, inspection, and packaging of the lot 8130019.The history record indicates this product was final inspection tested at (b)(6) medical and was determined to be acceptable.Product analysis cannot be conducted as the product was not returned for analysis.No determination of causes and possible contributing factors could be made.As such, the investigation will be closed.With the information available and without the complaint product available to be returned for analysis, the reported issue documented in the complaint cannot be confirmed through functional evaluation and analysis.Based on the manufacturing documentation review, there is no indication that the event is related to the device manufacturing process.Assignment of root cause for the event remains speculative and inconclusive, based on the limited information provided and without the return of the complaint sample; however, it is possible that clinical and procedural factors, including device manipulation / interaction may have contributed to the reported failure.As part of the post market surveillance program, information from this complaint is trended for statistical signals and corrective / preventive action may be triggered at a later time.Since there was no evidence to suggest the event was related to a manufacturing or design issue, no corrective actions will be taken at this time.This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by cerenovus, or its employees that the report constitutes an admission that the product, cerenovus, or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.Missing information from this report is identified as blank; this information was not provided in the reported event or available at the time of report submission.The manufacturer will submit a supplemental report if new facts arise which materially alter information submitted in a previous mdr report.Additional information will be submitted within 30 days of receipt.
 
Event Description
The healthcare professional reported that during a vascular stent placement procedure, the distal end of the complaint device, a 4mm x 23mm enterprise 2 stent (encr402312 / 8130019) did not fully open or expand as intended.After several attempts, the stent was still having the same issue.The physician retracted the stent and switched to a new stent to complete the procedure using the original microcatheter.The procedure was prolonged by approximately 30 minutes.There was no report of any negative patient impact.On 14-nov-2023, additional information was received.Per the information, the target was a ruptured aneurysm at the ophthalmic artery.There was no evidence of obstructed blood flow due to the reported issue.The temperature indicator label on the inner pouch was checked and found to be within acceptable criteria.The microcatheter used was a prowler select plus microcatheter (606s255x / 31028210).There was no damage noted on the microcatheter.The replacement stent was another 4mm x 23mm enterprise 2 stent (encr402312).The physician did not consider the 30 minutes procedure extension to be clinically significant.The additional information confirmed there was no negative patient impact.
 
Manufacturer Narrative
Manufacturer¿s ref.No: (b)(4).The purpose of this mdr submission is to include the additional event information received on 22-nov-2023.[additional information]: on 22-nov-2023, additional information was received.Per the information, the procedure was a stent-assisted embolization of an ophthalmic artery aneurysm.The manufacturer will submit a supplemental report if new facts arise which materially alter information submitted in a previous mdr report.Additional information will be submitted within 30 days of receipt.
 
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Brand Name
ENTERPRISE2 4MMX23MM
Type of Device
INTRACRANIAL NEUROVASCULAR STENT
Manufacturer (Section D)
MEDOS INTERNATIONAL SARL
chemin-blanc 38
le locle neuchatel CH-24 00
SZ  CH-2400
Manufacturer (Section G)
CERENOVUS, INC.
325 paramount dr
raynham MA 02767
Manufacturer Contact
kate karberg
31 technology dr
irvine, CA 92618
303552-689
MDR Report Key18184652
MDR Text Key328944939
Report Number3008114965-2023-00830
Device Sequence Number1
Product Code NJE
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
H60001
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 11/22/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberENCR402312
Device Lot Number8130019
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 11/09/2023
Initial Date FDA Received11/21/2023
Supplement Dates Manufacturer Received11/22/2023
Supplement Dates FDA Received11/22/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/15/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
PROWLER SELECT PLUS 150/5CM
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