MAUDE Adverse Event Report: MEDOS INTERNATIONAL SARL GALAXY G3 8MM X 24CM; NEUROVASCULAR EMBOLIZATION DEVICE

Model Number	GLY120824
Medical Device Problem Code	Stretched (1601)
Health Effect - Clinical Code	No Consequences Or Impact To Patient (2199)
Date of Event	02/17/2020
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
(b)(4).The purpose of this mdr submission is to report the findings of the device investigation.The embolic coil was noted to being stretched, meeting regulatory reporting criteria.Information regarding patient weight, height, medical history, race, and ethnicity was not reported.Procode: krd/hcg.Initial reporter phone: (b)(6).A supplemental report will be submitted if new facts arise which materially alter information submitted in a previous mdr report.This is one of three products involved with the complaint and the associated manufacturer report numbers are 3008114965-2020-00107 and 3008114965-2020-00109.Complaint conclusion: as reported by a healthcare professional, during a coil embolization at the right gastric artery, a 12mm x 40cm micrusframe18 (mfr181240, l16839) was attempted to be used, but its size did not fit and could not be re-sheathed, therefore, the coil was removed.After that, the framing was made with other micrusframes coils.Then a 8mm x 24cm galaxy g3 (gly120824, l15747) was attempted to be used as a filling coil, but it got stuck in the microcatheter.Therefore, the complaint coil was replaced with another one, and it was implanted.There was also resistance felt between the microcatheter and a 3mm x 8cm galaxy g3 coil (gly120308, l16564).The procedure was completed safely.Two microcatheters (excelcior 1018, stryker) were also used for this procedure.A (mm x 12cm deltafill18 coil had been used as the first coil.The customer states there is no additional information available.One non-sterile unit galaxy g3 8mm x 24cm was received inside of a pouch.The received device was visually inspected, and the introducer was found damaged and partially zipped, the dpu was found with several kinks.Then a microscopic inspection was performed, the embolic coil was found stretched inside the introducer, no other damages were observed.A manufacturing record evaluation was performed for the finished device l15747 number, and no non-conformances related to the reported complaint condition were identified.The complaint reported by the customer ¿detachable coil delivery system (dcs)- impeded in microcatheter with no loss of cerebral target position¿ was confirmed.Even through the functional analysis could not be performed, the dpu could not move through the introducer and due to these conditions of the device, the event was confirmed.However, the dpu was found kinked and the embolic coil was found stretched and this can contribute to an impediment.The damaged condition noted on the device appears to have been caused by excessive force and handling being applied to the device however none of those can be conclusively determined.Neither the device history record review nor the product analysis suggest that the reported failure could be related to the manufacturing process of the unit.The instructions for use (ifu) warns that if the microcoil system becomes immobile in the infusion microcatheter, apply a gentle push-pull motion to free it.If unsuccessful, remove both microcatheter and microcoil system together as a unit and replace with new devices.Assignment of root cause for the event remains speculative and inconclusive, based on the limited information provided and the evidence presented by the returned device; however, it is possible that clinical and procedural factors, including device manipulation and device interaction, may have contributed to the reported failure and damages on the returned system.Generally, stretching is caused by the application of excessive force to a device while trying to retract against resistance.As part of the post market surveillance program, information from this complaint is trended to identify statistical signals for consideration of further correction action.Since there was no evidence to suggest the event was related to a manufacturing or design issue, no corrective actions will be taken at this time.
Event or Problem Description
As reported by a healthcare professional, during a coil embolization at the right gastric artery, a 12mm x 40cm micrusframe18 (mfr181240, l16839) was attempted to be used, but its size did not fit and could not be re-sheathed, therefore, the coil was removed.After that, the framing was made with other micrusframes coils.Then a 8mm x 24cm galaxy g3 (gly120824, l15747) was attempted to be used as a filling coil, but it got stuck in the microcatheter.Therefore, the complaint coil was replaced with another one, and it was implanted.There was also resistance felt between the microcatheter and a 3mm x 8cm galaxy g3 coil (gly120308, l16564).The procedure was completed safely.Two microcatheters (excelcior 1018, stryker) were also used for this procedure.A (mm x 12cm deltafill18 coil had been used as the first coil.The customer states there is no additional information available.Based on the product analysis of the 8mm x 24cm galaxy g3, the embolic coil was found stretched.

• Brand Name: GALAXY G3 8MM X 24CM
• Common Device Name: NEUROVASCULAR EMBOLIZATION DEVICE
• Manufacturer (Section D): MEDOS INTERNATIONAL SARL; chemin-blanc 38; le locle neuchatel CH-24 00; SZ CH-2400
• MDR Report Key: 9967914
• Report Number: 3008114965-2020-00108
• Device Sequence Number: 4597354
• Product Code: KRD
• UDI-Device Identifier: 10886704077589
• UDI-Public: 10886704077589
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K150319
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: foreign,health professional
• Initial Reporter Occupation: Physician
• Type of Report: Initial
• Report Date (Section B): 02/17/2020

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: 04/30/2022
• Device Model Number: GLY120824
• Device Catalogue Number: GLY120824
• Device Lot Number: L15747
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 03/25/2020
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 03/31/2020
• Initial Report FDA Received Date: 04/16/2020
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1