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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ANGIOMED GMBH & CO. MEDIZINTECHNIK KG LIFESTENT VASCULAR STENT

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ANGIOMED GMBH & CO. MEDIZINTECHNIK KG LIFESTENT VASCULAR STENT Back to Search Results
Model Number EX061703CS
Device Problems Difficult to Remove (1528); Detachment of Device or Device Component (2907); Device-Device Incompatibility (2919); Material Deformation (2976)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 08/31/2022
Event Type  malfunction  
Manufacturer Narrative
As the lot number for the device was provided, a review of the device history records is currently being performed.The device has been returned to the manufacturer for evaluation and images were provided for review.The investigation of the reported event is currently underway.Expiry date: 02/2024.
 
Event Description
It was reported that during a stent placement procedure in the right superficial femoral artery via contralateral approach, the stent allegedly foreshortened.The procedure was completed using another device.There was no reported patient injury.
 
Event Description
It was reported that during a stent placement procedure in the right superficial femoral artery via contralateral approach, the stent allegedly foreshortened.The procedure was completed using another device.There was no reported patient injury.
 
Manufacturer Narrative
H10: manufacturing review: the lot history records of this lot were reviewed with special attention to the manufacturing and inspection of this product and the product was found to have met the specification prior to shipment.Investigation summary: the stent delivery system was returned for evaluation and was found in used condition without stent, which was completely deployed.The delivery sheath of the system was found stuck inside a device compatible 6f introducer sheath and loaded over a device compatible 0.035 inch guidewire.A joint inside the delivery system was found detached.Based on sample condition no indication for stent foreshortening could be found; x-ray images were provided, but with poor, dotty resolution so that a strut evaluation or length measurement was not possible, which leads to inconclusive result for stent foreshortening.The investigation will be closed as confirmed for detachment, difficult removal, and difficulties to remove the guidewire and introducer sheath.Based on the information available the investigation is inconclusive for stent foreshortening and confirmed for difficulty removal, detachment, and device incompatibility.A definite root cause for the reported event could not be determined based upon the available information.Labeling review: in reviewing the relevant labeling for this product the potential issue was found addressed.The instructions for use closely describes holding and handling of the system during deployment, in particular the instructions for use state: 'remove slack from the stent system held outside the patient.', 'confirm that the introducer sheath is secure and will not move during deployment.', and 'to ensure the most accurate placement, firmly hold the black system stability sheath throughout deployment.Note: do not hold the silver stent delivery sheath at any time during deployment.Do not constrict the stent delivery sheath during stent deployment.' in regards to access and accessories the instructions for use state: 'gain femoral access at the appropriate site using a 6f (2.0 mm) or larger introducer sheath (.) insert a 0.035¿ diameter guidewire of appropriate length'.The instructions for use further state: predilation of the lesion should be performed using standard techniques.', and 'if resistance is met during stent system introduction, the stent system should be removed and another stent system should be used.', and 'if resistance is met while retracting the delivery system over a guidewire, remove the delivery system and guidewire together.' h10: d4 (expiry date: 02/2024), g3, h6 (device, method).H11: section a through f: the information provide by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
 
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Brand Name
LIFESTENT VASCULAR STENT
Type of Device
VASCULAR STENT
Manufacturer (Section D)
ANGIOMED GMBH & CO. MEDIZINTECHNIK KG
wachhausstr. 6
karlsruhe 76227
GM  76227
Manufacturer (Section G)
ANGIOMED GMBH & CO. MEDIZINTECHNIK KG
wachhausstr. 6
karlsruhe 76227
GM   76227
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key15453790
MDR Text Key305887153
Report Number9681442-2022-00286
Device Sequence Number1
Product Code NIP
UDI-Device Identifier04049519000961
UDI-Public(01)04049519000961
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P070014
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Health Professional,User Facility,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 09/30/2022
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
Device Operator Health Professional
Device Model NumberEX061703CS
Device Catalogue NumberEX061703CS
Device Lot NumberANGP1396
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/19/2022
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 08/31/2022
Initial Date FDA Received09/20/2022
Supplement Dates Manufacturer Received10/10/2022
Supplement Dates FDA Received10/18/2022
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Age77 YR
Patient SexFemale
Patient Weight68 KG
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