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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MICRO THERAPEUTICS, INC. DBA EV3 PIPELINE FLEX W/SHIELD TECHNOLOGY; INTRACRANIAL ANEURYSM FLOW DIVERTER

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MICRO THERAPEUTICS, INC. DBA EV3 PIPELINE FLEX W/SHIELD TECHNOLOGY; INTRACRANIAL ANEURYSM FLOW DIVERTER Back to Search Results
Model Number PED2-475-16
Medical Device Problem Code Activation Failure (3270)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/17/2026
Type of Reportable Event Malfunction
Event or Problem Description
Medtronic received a report that a pipeline failed to open at the distal section.It was reported that physician felt he was unable to get the pipeline sleeves to open after trying every suggested method requested a different device.The pipeline failed to open at the distal section.The pipeline was not positioned in a bend and did not get stuck in the capture coil.More than 50% of the pipeline deployed when it failed to open.The pipeline was resheathed less than or equal to 2 times and removed from the patient with the microcatheter.No additional steps or other devices were required to open the pipeline.The pipeline and all accessory devices were prepared as indicated in the ifu.No patient complications were associated with this event.
 
Additional Manufacturer Narrative
Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide 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.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Additional Manufacturer Narrative
Update b5 medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide 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.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
Additional information was received.The cause was undetermined.The physician suspected anatomy and recapture contributed to the distal portion not opening.
 
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Brand Name
PIPELINE FLEX W/SHIELD TECHNOLOGY
Common Device Name
INTRACRANIAL ANEURYSM FLOW DIVERTER
Manufacturer (Section D)
MICRO THERAPEUTICS, INC. DBA EV3
9775 toledo way
irvine CA 92618
Manufacturer (Section G)
MICRO THERAPEUTICS, INC. DBA EV3
9775 toledo way
irvine CA 92618
Manufacturer Contact
justin ellis
9775 toledo way
irvine, CA 92618
7635265677
MDR Report Key24123219
Report Number2029214-2026-00114
Device Sequence Number17615022
Product Code OUT
UDI-Device Identifier00763000449452
UDI-Public(01)00763000449452(17)280905(10)D063115
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
P100018
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 03/04/2026
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 Model NumberPED2-475-16
Device Catalogue NumberPED2-475-16
Device Lot NumberD063115
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/17/2026
Supplement Date Received by Manufacturer02/06/2026
Initial Report FDA Received Date01/20/2026
Supplement Report FDA Received Date03/04/2026
Date Device Manufactured09/06/2025
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 Number1
Patient SexUnknown
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