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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. MARQUEE; BIOPSY INSTRUMENT

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BARD PERIPHERAL VASCULAR, INC. MARQUEE; BIOPSY INSTRUMENT Back to Search Results
Catalog Number MQ1410
Device Problem Detachment of Device or Device Component (2907)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/02/2024
Event Type  malfunction  
Event Description
It was reported that during an ultrasound guided breast biopsy through normal scattered density tissue, as the device was being removed, the needle of the device allegedly kept getting longer and did not completely come out of the coaxial.It was further reported that the cutting needle with the strips that covers the trough was allegedly found to detached from the biopsy unit.Reportedly, the white portion of the biopsy device and the end of the cutting needle were held in order to prevent it from completely detaching.There was no reported patient injury.
 
Manufacturer Narrative
H10: as the lot number for the device was provided, a review of the device history records will be performed.The sample was not returned to the manufacturer for inspection evaluation.Therefore, the investigation of the reported event is inconclusive.Based upon the available information, the definitive root cause for this event is unknown.The instructions for use (ifu) is adequate for the reported device patient code(s) and provides general instructions for use, as well as warnings, precautions and potential complications associated with the device.Upon receipt of new or additional information, a follow-up report will be submitted as applicable.H10: d4: (expiry date: 08/2026).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
MARQUEE
Type of Device
BIOPSY INSTRUMENT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
CAREFUSION D.R. 203 LTD.
zona franca las americas
km 22-e-1
santo domingo 11606
DR   11606
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key18795345
MDR Text Key337086825
Report Number2020394-2024-00283
Device Sequence Number1
Product Code KNW
UDI-Device Identifier00801741097133
UDI-Public(01)00801741097133
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K133948
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
Report Date 02/12/2024
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 NumberMQ1410
Device Lot Number0001533397
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/02/2024
Initial Date FDA Received02/28/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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 Age75 YR
Patient SexFemale
Patient Weight93 KG
Patient RaceWhite
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