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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRAUB MEDICAL AG ROTAREX; THROMBECTOMY & ATHERECTOMY

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STRAUB MEDICAL AG ROTAREX; THROMBECTOMY & ATHERECTOMY Back to Search Results
Catalog Number 80237
Device Problems Break (1069); Detachment of Device or Device Component (2907)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/23/2024
Event Type  malfunction  
Event Description
It was reported that during a recanalization procedure, the helix allegedly separated.Reportedly, the helix was removed over the wire.There was no reported patient injury.
 
Manufacturer Narrative
H10: the medical device manufacturer (d3) and manufacturing location (g1) for the straub product was selected as unknown due to system limitations.The correct medical device manufacturer and manufacturing location are straub medical us.H10: as the lot number for the device was provided, a review of the device history records is currently being performed.The return of the sample is pending.The investigation of the reported event is currently underway.H10: d4 (expiry date: 07/2026).H11: section a through f ¿ the information provided 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.
 
Event Description
It was reported that during a thrombectomy and atherectomy procedure in a superficial femoral artery stent via the contralateral approach, upon removal of the catheter from the patient, the helix allegedly separated.It was further reported that the segment was within the sheath, so it was able to be removed without any issues.There was no reported patient injury.
 
Manufacturer Narrative
H10: manufacturing review: a manufacturing review was conducted and there was nothing found to indicate there was a manufacturing related cause for this event.Investigation summary: the physical sample was returned for evaluation and a physical investigation was performed for the catheter.During physical investigation the helix was broken at 59.5 cm distance from the tip of the catheter.The tube was kinked at the same position 59.5 cm from the tip of the catheter.Therefore, the investigation is confirmed for the reported helix break issue.A definitive root cause could not be determined based upon the available information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.H10: d4 (expiry date: 07/2026).H11: section a through f ¿ the information provided 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
ROTAREX
Type of Device
THROMBECTOMY & ATHERECTOMY
Manufacturer (Section D)
STRAUB MEDICAL AG
straubstrasse 12
ch-7323
wangs SG 73 23
SZ  SG 7323
Manufacturer (Section G)
STRAUB MEDICAL AG
straubstrasse 12
ch-7323
wangs SG 73 23
SZ   SG 7323
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key18738817
MDR Text Key335753065
Report Number3008439199-2024-00021
Device Sequence Number1
Product Code MCW
UDI-Device Identifier07640142810582
UDI-Public(01)07640142810582
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K211738
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 04/05/2024
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 Catalogue Number80237
Device Lot Number231229
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 01/23/2024
Initial Date FDA Received02/20/2024
Supplement Dates Manufacturer Received04/05/2024
Supplement Dates FDA Received04/12/2024
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
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