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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PENUMBRA, INC. PENUMBRA SYSTEM 3MAX REPERFUSION CATHETER; NRY

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PENUMBRA, INC. PENUMBRA SYSTEM 3MAX REPERFUSION CATHETER; NRY Back to Search Results
Catalog Number 3MAXC
Device Problems Kinked (1339); Device Damaged Prior to Use (2284); Out-Of-Box Failure (2311)
Patient Problem No Patient Involvement (2645)
Event Date 11/05/2017
Event Type  malfunction  
Manufacturer Narrative
Results: the penumbra system 3max reperfusion catheter (3maxc) was fractured approximately 29.0 cm from the hub.Conclusions: evaluation of the returned device revealed that the 3maxc was fractured.This damage may have occurred due to forceful handling of the 3maxc at extreme angles during removal from the packaging hoop.Penumbra catheters are inspected during in-process inspection and during quality inspection after manufacturing.The manufacturing records for this lot were reviewed and did not reveal any outstanding discrepancies, design, or quality concerns.
 
Event Description
During preparation for a thrombectomy procedure, the hospital staff noticed that the penumbra system 3max reperfusion catheter (3maxc) was kinked upon removal from the packaging.The damaged 3maxc was found prior to use and therefore, the 3maxc was not used in the procedure.The procedure was completed using another 3maxc.
 
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Brand Name
PENUMBRA SYSTEM 3MAX REPERFUSION CATHETER
Type of Device
NRY
Manufacturer (Section D)
PENUMBRA, INC.
one penumbra place
alameda CA 94502
Manufacturer Contact
veronica farris
one penumbra place
alameda, CA 94502
5107483200
MDR Report Key7083438
MDR Text Key94366282
Report Number3005168196-2017-02123
Device Sequence Number1
Product Code NRY
UDI-Device Identifier00814548012490
UDI-Public00814548012490
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
K160449
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Physician
Type of Report Initial
Report Date 11/06/2017
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/05/2017
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date08/08/2020
Device Catalogue Number3MAXC
Device Lot NumberF78592
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/20/2017
Is the Reporter a Health Professional? Yes
Date Manufacturer Received11/06/2017
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/09/2017
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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