| Catalog Number |
M0036181040 |
| Medical Device Problem Code |
Premature Separation (4045)
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| Health Effect - Clinical Code |
No Clinical Signs, Symptoms or Conditions (4582)
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| Date of Event |
10/29/2025
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Type of Reportable Event
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Malfunction
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Event or Problem Description
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It was reported that the coil (subject device) was used in the medical procedure.However, resistance was encountered at the proximal end of microcatheter when the subject coil was inserted.Also, the subject coil got prematurely detached within the microcatheter when the physician attempted to pull it back.The subject device was replaced, and the procedure was completed successfully.No clinical consequences were reported to the patient.
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Additional Manufacturer Narrative
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Due to the automated manufacturing execution system (mes) there are controls in the manufacturing process to ensure the product met specifications upon release.The subject device was not available; therefore, a visual inspection as well as a functional evaluation could not be performed.The reported complaint could not be confirmed, and it could not be definitively determined if the device failed to meet specifications because the product was not returned.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.It was reported that during coil embolization; while inserting the coil into a microcatheter, resistance was encountered at the proximal end of the microcatheter.When the coil was pulled back it detached prematurely in the microcatheter.The coil was replaced with another coil of the same kind, and the procedure was completed successfully.Additional information provided by the customer indicated that there was no friction noted inside the introducer sheath.The microcatheter used was noted to have an id (internal diameter) which is larger than the recommended max id of 0.019inch.This is likely to have contributed to the friction and subsequent detachment.Based on review of all available information an assignable cause of use error will be assigned to this complaint as the investigation confirms that there was the use of an incorrectly sized product; a deviation from the supplied dfu that resulted in a different medical product response than intended by the manufacturer or expected by the user.
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Event or Problem Description
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It was reported that the coil (subject device) was used in the medical procedure.However, resistance was encountered at the proximal end of microcatheter when the subject coil was inserted.Also, the subject coil got prematurely detached within the microcatheter when the physician attempted to pull it back.The subject device was replaced, and the procedure was completed successfully.No clinical consequences were reported to the patient.
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Search Alerts/Recalls
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