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U.S. Department of Health and Human Services

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

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PENUMBRA, INC. PENUMBRA SYSTEM 3 MAX 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 10/30/2017
Event Type  malfunction  
Manufacturer Narrative
This device is available for return.A follow up mdr will be submitted upon completion of the device investigation.
 
Event Description
During preparation for a thrombectomy procedure, the hospital staff noticed that a penumbra system 3max reperfusion catheter (3maxc) was kinked at the proximal hub upon removal from the dispenser hoop.The damaged 3maxc was found prior to use and therefore, was not used in the procedure.The procedure was completed using a penumbra system ace 68 reperfusion catheter (ace68).
 
Manufacturer Narrative
Results: the 3maxc was fractured approximately 47.0 cm from the hub.Conclusions: evaluation of the returned device revealed it was fractured.This damage may have occurred due to forceful handling of the 3maxc at extreme angles during removal from the packaging.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.
 
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Brand Name
PENUMBRA SYSTEM 3 MAX 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 Key7083887
MDR Text Key94898850
Report Number3005168196-2017-02118
Device Sequence Number1
Product Code NRY
UDI-Device Identifier00814548012490
UDI-Public00814548012490
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
K160449
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 11/05/2017
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 Date06/12/2020
Device Catalogue Number3MAXC
Device Lot NumberF77597
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/20/2017
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 11/05/2017
Initial Date FDA Received12/05/2017
Supplement Dates Manufacturer Received01/19/2018
Supplement Dates FDA Received02/13/2018
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured06/13/2017
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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