MAUDE Adverse Event Report: INVATEC SPA MO.MA; CATHETER, CAROTID, TEMPORARY, FOR EMBOLIZATION CAPTURE

Device Problem Adverse Event Without Identified Device or Use Problem (2993)

Patient Problem Patient Problem/Medical Problem (2688)

Event Date 04/01/2019

Event Type  Injury  

Manufacturer Narrative

Journal of the american college of cardiology, vol.73, no.15, suppl s, 2019 endovascular: carotid neurovascular intervention (tctap a-065) tctap a-065.Prospective multi-center study of carotid artery stenting using mer stent: oceanus study.If information is provided in the future, a supplemental report will be issued.

Event Description

Multicentre prospective registry carotid artery stenting using new polish open-cells carotid stent mer involving 100 patients with symptomatic or asymptomatic carotid disease, who qualificated for carotid artery stenting.45% of patients were symptomatic.A neuroprotection system used 100% of the time.Spider fx and moma were included as being used during the procedures.Minor stroke (1% of patient¿s) and hypotonia (1% of patient¿s) is reported in patient¿s after minor stroke after rehabilitation without any paresis.

Manufacturer Narrative

Updated section b.Relevant history.Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.

• Brand Name: MO.MA
• Type of Device: CATHETER, CAROTID, TEMPORARY, FOR EMBOLIZATION CAPTURE
• Manufacturer (Section D): INVATEC SPA; via martiri della liberta, 7; roncadelle 25030 ; IT 25030
• MDR Report Key: 8646098
• MDR Text Key: 146239202
• Report Number: 3004066202-2019-00025
• Device Sequence Number: 1
• Product Code: NTE
• Combination Product (y/n): N
• PMA/PMN Number: K092177
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,foreig
• Type of Report: Initial,Followup
• Report Date: 07/23/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Device Operator: Health Professional
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 05/15/2019
• Initial Date FDA Received: 05/28/2019
• Supplement Dates Manufacturer Received: 07/17/2020
• Supplement Dates FDA Received: 07/23/2020
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1
• Patient Age: 69 YR