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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION INNOVA VASCULAR; STENT, SUPERFICIAL FEMORAL ARTERY

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BOSTON SCIENTIFIC CORPORATION INNOVA VASCULAR; STENT, SUPERFICIAL FEMORAL ARTERY Back to Search Results
Model Number 26926
Device Problems Fracture (1260); Activation, Positioning or Separation Problem (2906); Difficult to Advance (2920)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/19/2024
Event Type  Injury  
Event Description
It was noted that stent partial deployment and stent fracture occurred.The 99% stenosed target lesion was located in the mildly tortuous and mildly calcified left distal superficial femoral artery and external iliac artery.Physician had crossed an old occluded in-stent stenosis.A laser atherectomy was then performed to prepare the vessel prior to deployment of the stent.Afterwards, a 5 x 150 x 130 innova stent was sent to realign the fractured old stent segment.However, physician struggled to track stent over a.014 pt choice wire, but eventually aligned stent where it was wanted.During the deployment, it was noted that the thumb wheel was not deploying the stent and when it was retracted, the stent was partially deployed about 10mm.Part of the stent was still in the body as the remaining stent was now located in the sheath, so the sheath and stent was removed together.The physician decided to send a sterling balloon catheter to deploy the remaining stent portion and the procedure was completed with a 6x60 innova.No patient complications were reported.
 
Manufacturer Narrative
Device evaluated by mfr: the complaint device was received for product analysis.The outer sheath, tip, inner sheath and the remainder of the device were checked for damage.Visual examination revealed that the handle is open.The middle sheath is separated 16cm from the distal end.There are multiple areas of buckling to the outer and middle sheath.The pull rack is separated.The separated distal section is stuck inside the nosecone while the separated proximal section is missing.The stent is no longer inside the middle sheath.Inspection of the remainder of the device, revealed no other damage or irregularities.The information provided suggested the customer used an undersized guidewire during deployment which likely led to insufficient support contributing damage found during analysis and the report from the field.
 
Event Description
It was noted that stent partial deployment and stent fracture occurred.The 99% stenosed target lesion was located in the mildly tortuous and mildly calcified left distal superficial femoral artery and external iliac artery.Physician had crossed an old occluded in-stent stenosis.A laser atherectomy was then performed to prepare the vessel prior to deployment of the stent.Afterwards, a 5 x 150 x 130 innova stent was sent to realign the fractured old stent segment.However, physician struggled to track stent over a.014 pt choice wire, but eventually aligned stent where it was wanted.During the deployment, it was noted that the thumb wheel was not deploying the stent and when it was retracted, the stent was partially deployed about 10mm.Part of the stent was still in the body as the remaining stent was now located in the sheath, so the sheath and stent was removed together.The physician decided to send a sterling balloon catheter to deploy the remaining stent portion and the procedure was completed with a 6x60 innova.No patient complications were reported.
 
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Brand Name
INNOVA VASCULAR
Type of Device
STENT, SUPERFICIAL FEMORAL ARTERY
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
two scimed place
maple grove MN 55311
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key18912302
MDR Text Key337756962
Report Number2124215-2024-12688
Device Sequence Number1
Product Code NIP
UDI-Device Identifier08714729873952
UDI-Public08714729873952
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P140028
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 04/10/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number26926
Device Catalogue Number26926
Device Lot Number0032186978
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/19/2024
Initial Date FDA Received03/15/2024
Supplement Dates Manufacturer Received03/20/2024
Supplement Dates FDA Received04/10/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/10/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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