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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT VASCULAR SUPERA SELF-EXPANDING STENT SYSTEM; SELF EXPANDING PERIPHERAL STENT SYSTEM

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ABBOTT VASCULAR SUPERA SELF-EXPANDING STENT SYSTEM; SELF EXPANDING PERIPHERAL STENT SYSTEM Back to Search Results
Catalog Number S-55-150-120-P6
Device Problems Difficult to Remove (1528); Material Separation (1562); Difficult to Advance (2920)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/17/2024
Event Type  malfunction  
Event Description
It was reported that the procedure was to treat a chronic total occlusion in the right distal superficial femoral artery with moderate calcification.During preparation of the 5.5x150 mm supera self expanding stent system (sess), the device was loaded onto a guide wire which was inside the anatomy.The guide wire wire had lots of contrast and was sticky, causing resistance during advancement and removal.When the stent was pulled off the wire, the white tip separated.Therefore, the stent was not used in the patient and another same size supera was used to complete the procedure.There were no adverse patient effects and there was no clinically significant delay in the procedure.No additional information was provided.
 
Manufacturer Narrative
Manufacturer's investigation is still pending at this time.Results and conclusions will be provided in the final report.
 
Manufacturer Narrative
The device was returned for analysis.The reported material separation tip was able to be confirmed.The reported difficult to advance and the reported difficult to remove were unable to be replicated in a testing environment due to the condition of the returned device.A review of the lot history record identified no manufacturing nonconformities issued to the reported lot that would have contributed to this event.Additionally, a review of the complaint history identified no other incidents from this lot.The investigation determined the reported difficulties appear to be related to circumstances of the procedure as it is likely that a coagulation of blood and contrast on the guide wire resulted in the reported difficult to advance and the reported difficult to remove.Manipulation of the compromised device resulted in the noted multiple distal sheath kinks and ultimately resulted in the reported tip separation/noted inner member/ tip jacket separations; thus resulting in the noted partially deployed/flowered stent.There is no indication of a product quality issue with respect to manufacture, design or labeling.
 
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Brand Name
SUPERA SELF-EXPANDING STENT SYSTEM
Type of Device
SELF EXPANDING PERIPHERAL STENT SYSTEM
Manufacturer (Section D)
ABBOTT VASCULAR
26531 ynez rd.
temecula CA 92591 4628
Manufacturer (Section G)
ABBOTT VASCULAR, REG # 2024168
26531 ynez road
temecula CA 92591 4628
Manufacturer Contact
lindsey bell
26531 ynez rd.
temecula, CA 92591-4628
9519143996
MDR Report Key18655622
MDR Text Key335294968
Report Number2024168-2024-01498
Device Sequence Number1
Product Code NIP
UDI-Device Identifier08717648226168
UDI-Public08717648226168
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P120020
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 03/07/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/06/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberS-55-150-120-P6
Device Lot Number3051061
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/31/2024
Is the Reporter a Health Professional? Yes
Date Manufacturer Received02/23/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/10/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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