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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM; CATHETER, HEMODIALYSIS, IMPLA

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ARROW INTERNATIONAL LLC ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM; CATHETER, HEMODIALYSIS, IMPLA Back to Search Results
Catalog Number CS-15242-VSP
Device Problem Deformation Due to Compressive Stress (2889)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/13/2023
Event Type  malfunction  
Manufacturer Narrative
(b)(4).
 
Event Description
It was reported that: (b)(6) 2023, the swg was found kinked prior to use.There was no patient involvement.
 
Event Description
It was reported that: (b)(6) 2023, the swg was found kinked prior to use.There was no patient involvement.
 
Manufacturer Narrative
(b)(4).The customer returned one guide wire assembly for analysis.It was noted that the guide wire was extended out of the straightener tube and the end cap ((b)(4)) was not returned with the sample.No definite signs of use were observed.Visual analysis revealed that the returned guide wire was kinked towards the distal end.Microscopic examination confirmed the damage and revealed that the distal and proximal welds were secure and intact.A lab inventory cap was assembled to the returned device.During normal assembly, the location of the kinking would be located within the straightener tube, protecting it from damage.Comparison of the returned assembly and individual guide wire component with the product drawings revealed that the returned sample assembly is not the same guide wire normally packaged within the reported finished good.Further dimensional analysis of the returned guide wire revealed that both the length and outer diameter are outside the specification limits.Based on this, it is unknown if the customer returned the wrong device, or if they reported the wrong finished good.The kink on the guide wire measured 32mm from the distal weld.The guide wire total length measured 68.4cm, which is not within the specification limits of 98.75cm-101.25cm per the guide wire product drawing.The guide wire outer diameter measured 0.0335", which is not within the specification limits of 0.0370"-0.0385".The discrepancy with the guide wire length and outer diameter indicates that the customer either returned the incorrect device or reported the incorrect part number.The returned swg was functionally tested per the instructions for use (ifu).The ifu provided with this kit states, "advance swg in routine fashion to desired depth".The undamaged portions of the wire passed through a lab inventory introducer needle with little to no issue.A manual tug test confirmed the distal and proximal welds were secure.A device history record review was performed and no relevant findings were identified.The ifu provided with the kit informs the user, "do not use if package is damaged".The report of a guide wire kinking was confirmed through complaint investigation of the returned sample.Visual analysis revealed that the guide wire was kinked; however, during normal assembly, the kinked area would be protected by the straightener tube from the advancer assembly.The end cap, which was not returned, functions to keep the guidewire contained within the advancer assembly.Further dimensional analysis revealed that the individual guide wire and full guide wire assembly are not the same components normally packaged within the reported finished good.Despite this, the sample met all relevant functional testing, and a device history record review of the reported batch did not reveal any relevant findings.Based on the customer report and the sample received, the root cause cannot be determined based on the dimensional discrepancy between the returned device and the reported part number.Teleflex will continue to monitor and trend for reports of this nature.
 
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Brand Name
ARROW HEMODIALYSIS KIT: 2-L 15 FR X 19 CM
Type of Device
CATHETER, HEMODIALYSIS, IMPLA
Manufacturer (Section D)
ARROW INTERNATIONAL LLC
morrisville NC
Manufacturer (Section G)
ARROW INTERNATIONAL DE MEXICO S.A. DE C.V.
ave. washington 3701
colonia panamericana, chihuahua
chihuahua 31200
MX   31200
Manufacturer Contact
katharine tarpley
3015 carrington mill blvd
morrisville, NC 27560
MDR Report Key18129118
MDR Text Key327995094
Report Number9680794-2023-00872
Device Sequence Number1
Product Code MSD
UDI-Device Identifier00801902096333
UDI-Public00801902096333
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
K111117
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,User Facility,Company Representative,Distributor
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 10/16/2023
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 Catalogue NumberCS-15242-VSP
Device Lot Number13F22L0602
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/13/2023
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 10/16/2023
Initial Date FDA Received11/14/2023
Supplement Dates Manufacturer Received12/04/2023
Supplement Dates FDA Received12/05/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured11/29/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
NOT REPORTED
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