MAUDE Adverse Event Report: STRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY TREVO NXT 6MM X 37MM - US; NEUROVASCULAR MECHANICAL THROMBECTOMY DEVICE FOR ACUTE ISCHEMIC STROKE TREATMENT

Model Number	90315
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/19/2021
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that during the acute ischemic stroke treatment procedure, the physician used the subject stent to collect the thrombus at the middle cerebral artery (mca).The technologist pushed the device out of the catheter after the first pass and the stent was cleaned and placed under the towel.The technologist didn't notice the stent was detached from the wire until later.The physician doesn¿t recall when the detachment occurred.The physician did not attempt to reuse the device once they noticed the fracture of the stent.The physician aborted the procedure, but not due to the stent detaching.It was also reported that the patient's anatomy was normally torturous.No clinical consequences were reported to the patient due to this event.
Additional Manufacturer Narrative
Based on the results of the dhr review, there is no indication that the device, labeling or packaging failed to meet its specifications when released.During the visual/ microscopic inspection, the retriever was returned detached.The retriever shaped section was flattened.The retriever was fractured at the core wire.The insertion tool was not returned.The polymer jacket is shown to have slight deformation noted, there is a bend on core wire just proximal to fracture site.Functional testing was not required as the core wire was fractured.The reported event is covered in the device directions for use (dfu).As well, the risk of the reported event is documented in the risk documentation and there are current controls to mitigate the risk of the as reported event.Additional information was received indicating that the device was confirmed to be in good condition prior to use.Based on the information provided, it is most likely that the stent retriever became detached from the device during cleaning of the device after the first pass.An assignable cause of handling damage will be assigned to the as reported (ar) defect of "retriever fracture/broken during use" and as analysed (aa) defects of "retriever core wire broken during preparation" and "retriever shaped section damage", because this complaint appears to be associated with handling of the product or portion of the product preparation of the product prior to use, a probable cause of handling damage was assigned.
Event or Problem Description
It was reported that during the acute ischemic stroke treatment procedure, the physician used the subject stent to collect the thrombus at the middle cerebral artery (mca).The technologist pushed the device out of the catheter after the first pass and the stent was cleaned and placed under the towel.The technologist didn't notice the stent was detached from the wire until later.The physician doesn¿t recall when the detachment occurred.The physician did not attempt to reuse the device once they noticed the fracture of the stent.The physician aborted the procedure, but not due to the stent detaching.It was also reported that the patient's anatomy was normally torturous.No clinical consequences were reported to the patient due to this event.

• Brand Name: TREVO NXT 6MM X 37MM - US
• Common Device Name: NEUROVASCULAR MECHANICAL THROMBECTOMY DEVICE FOR ACUTE ISCHEMIC STROKE TREATMENT
• Manufacturer (Section D): STRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY; 4870 west 2100 south; salt lake city UT 84120
• Manufacturer (Section G): STRYKER NEUROVASCULAR-UTAH-SALT LAKE CITY; 4870 west 2100 south; salt lake city UT 84120
• Manufacturer Contact: tara lopez ; 47900 bayside parkway; fremont, CA 94538 ; 5104132500
• MDR Report Key: 12513991
• Report Number: 3012931345-2021-00152
• Device Sequence Number: 5169304
• Product Code: POL
• UDI-Device Identifier: 07613327299953
• UDI-Public: 07613327299953
• Combination Product (Y/N): N
• Initial Reporter State: SC
• Initial Reporter Country: US
• PMA/510(K) Number: K200117
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup
• Report Date (Section B): 12/29/2021

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
• Operator of Device: Health Professional
• Device Expiration Date: 08/25/2022
• Device Model Number: 90315
• Device Catalogue Number: 90315
• Device Lot Number: 0000050621
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 09/15/2021
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 08/25/2021
• Supplement Date Received by Manufacturer: 12/01/2021
• Initial Report FDA Received Date: 09/22/2021
• Supplement Report FDA Received Date: 12/29/2021
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 08/26/2020
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: EXCELSIOR XT-27 MICROCATHETER (STRYKER); VECTA 71 INTERMEDIATE CATHETER (STRYKER); EXCELSIOR XT-27 MICROCATHETER (STRYKER); VECTA 71 INTERMEDIATE CATHETER (STRYKER)
• Patient Sex: Unknown