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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 PED2-300-12
Medical Device Problem Codes Packaging Problem (3007); Component Misassembled (4004); Inaccurate Information (4051)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/23/2026
Type of Reportable Event Malfunction
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.
 
Event or Problem Description
Medtronic received a report that when pipeline flex with shield technology stent opened it looked too big so they went with a different size.  the device was discarded and not used in the patient.Additional information received clarified that when deploying the pipeline it was realized it was way too long.It was believed that they had just gotten the sizing wrong, so they took it out and used a smaller size.It was never believed to be a packaging issue.
 
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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 Key25661024
Report Number2029214-2026-01181
Device Sequence Number13373882
Product Code OUT
UDI-Device Identifier00763000448806
UDI-Public(01)00763000448806(17)280903(10)D062612
Combination Product (Y/N)N
Initial Reporter StateNC
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 Health Professional,Company Representative
Initial Reporter Occupation Physician
Remedial Action Recall
Type of Report Initial
Report Date (Section B) 06/29/2026
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 NumberPED2-300-12
Device Catalogue NumberPED2-300-12
Device Lot NumberD062612
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 06/11/2026
Initial Report FDA Received Date06/29/2026
Date Device Manufactured09/04/2025
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
If action reported to FDA under 21 USC 360i(g), list
FDA-assigned Recall Number or include a statement
2029214-06-19-2026-001-R
Patient Sequence Number1
Patient SexUnknown
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