IFU Changes Mean Codman Neuro’s TRUFILL® n-BCA Liquid Embolic System Gets Class I Recall Status

Codman Neuro has announced changes to the instructions for use for its TRUFILL® n-BCA Liquid Embolic System. It seems incorrectly mixed product can result in embolization or reflux, which has lead the U.S. FDA to label the company’s medical device correction notice as a Class I recall.


TRUFILL® n-BCA is indicated for embolization of cerebral arteriovenous malformations (AVMs) when presurgical devascularization is desired. The use of incorrectly mixed product can result in the liquid mixture solidifying too slowly in unintended areas, which may lead to embolization or reflux into arteries and pulmonary vessels. This could result in significant impact to the patient, including neurological deficits, pulmonary emboli and possibly death.

Last October (2013), reportedly through routine internal procedures, Codman Neuro identified an incorrect statement in the product’s Instructions For Use (IFU) that described suggested mixing ratios for use in certain treatment conditions. The information provided was incorrect and should have read; “A 2:1 (67% Ethiodized Oil / 33% nBCA) for Intranidal injections without AV fistulae or high flow rates in order to more deeply penetrate the nidus.”

Products associated with the correction notice were manufactured between February 25, 2010 and October, 31, 2013, distributed to hospitals and surgical centers, and include the following codes (all lots):

Product Code 631400 (Two 1 gram tubes nBCA), Product Code 631500 (One 1 gram tube nBCA)

Once the problem had been confirmed, Codman Neuro duly informed the U.S. FDA and other regulatory authorities, and issued a corresponding correction notice to inform customers in the U.S., Costa Rica, Puerto Rico and Russia. Product is not being removed from the market. Instead the company is informing physicians of this incorrect statement and updating the product’s IFU.

No corresponding patient deaths or permanent patient injuries have been reported to date. When the product is mixed correctly, it is expected to perform as intended. Thorough product training is required before purchasing the TRUFILL® nBCA. The company has verified that all related physician training materials and promotional documents contain correct information.

Action required

All customers who have purchased TRUFILL® nBCA are reminded to review the correction notice and other product literature to ensure proper mixing procedures are followed. They may also call Codman Neuro with questions or to report any malfunction or adverse event on weekdays between the hours of 7:00am and 6:30pm Eastern Time at 1-866-491-0974, Option 2.

Source: Codman Neuro, PR Newswire, FDA

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