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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. IMPRA VASCULAR GRAFT; EPTFE VASCULAR GRAFT

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BARD PERIPHERAL VASCULAR, INC. IMPRA VASCULAR GRAFT; EPTFE VASCULAR GRAFT Back to Search Results
Model Number F8006TWS
Device Problem Torn Material (3024)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Type  malfunction  
Manufacturer Narrative
No hospital/medical records or medical images have been made available to the manufacturer.As the lot number for the device was provided, a review of the device history records is currently being performed.The device has been returned to the manufacturer for evaluation.The investigation of the reported event is currently underway.The information provided by bard represents all of 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 bard.
 
Event Description
It was reported that during prep, the vascular graft tore when the external spiral support was removed.There was no reported patient injury.No additional information was received.
 
Manufacturer Narrative
Manufacturing review: the device history records have been reviewed and this lot met all release criteria.There was nothing found to indicate there was a manufacturing related cause for this event.This is the only complaint reported to date for this lot number and failure mode.Visual inspection: two segment were returned.Blue lines and carbon lining were identified on the segment.The first graft segment measured 26cm in length.The segment had been cut on both ends.The beading was removed on one end of the segment.The segment was torn in this area along the beading track.The second segment measured 51.5cm in length.The segment appears to have been cut on both end.There were no other rips, tears, or suture marks in either of the returned segments.Dimensional evaluation: the total length of the segments was measured.The length of the graft was not measured to be within specification.Approximately 2.5cm of the graft was not returned for evaluation.Medical records review: no medical records have been made available to the manufacturer.Image/photo review: no medical images have been made available to the manufacturer.Conclusion: the device was returned for evaluation.The graft was returned in two segments.One segment was found to have spiral tearing along the beading track.Therefore, the investigation can be confirmed for the alleged torn material.The definitive root cause could not be determined based upon available information.It is unknown whether patient and/or procedural issues contributed to the event.Labeling review: the current ifu (instructions for use) states: warnings: do not remove the external spiral support (beading) from any centerflex¿ graft or endflex¿ graft.Attempts to remove the beading may damage the graft wall.If damage occurs, discard the graft.Precautions: when removing the external spiral support (beading) of impra flex¿ grafts, the beading must be removed slowly and at a 90° angle to the graft.Rapid unwinding and/or removal at less than a 90° angle may result in graft damage.Do not use surgical blades or sharp, pointed instruments to remove the beading as this may damage the graft wall.If damage occurs, that segment of the graft should not be used.
 
Event Description
It was reported that during prep, the vascular graft tore when the external spiral support was removed.There was no reported patient injury.No additional information was received.
 
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Brand Name
IMPRA VASCULAR GRAFT
Type of Device
EPTFE VASCULAR GRAFT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer Contact
judith ludwig
1625 w 3rd st.
tempe, AZ 85281
4803032689
MDR Report Key6588950
MDR Text Key75931549
Report Number2020394-2017-00510
Device Sequence Number1
Product Code DSY
UDI-Device Identifier00801741023286
UDI-Public(01)00801741023286(17)210204(10)VTAP0255
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K004011
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type foreign,health professional,u
Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date 07/25/2017
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 Expiration Date02/04/2021
Device Model NumberF8006TWS
Device Catalogue NumberF8006TWS
Device Lot NumberVTAP0255
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/12/2017
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 04/27/2017
Initial Date FDA Received05/24/2017
Supplement Dates Manufacturer Received07/19/2017
Supplement Dates FDA Received07/25/2017
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/17/2016
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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