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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PENUMBRA, INC. PENUMBRA SYSTEM JET7 REPERFUSION CATHETER; NRY

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PENUMBRA, INC. PENUMBRA SYSTEM JET7 REPERFUSION CATHETER; NRY Back to Search Results
Model Number 5MAXJET7KIT-B
Device Problem Stretched (1601)
Patient Problems No Consequences Or Impact To Patient (2199); No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/08/2020
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
The patient was undergoing a thrombectomy procedure in the m1 segment of the middle cerebral artery (mca) using a penumbra system jet7 reperfusion catheter (jet7), a penumbra system 3max reperfusion catheter (3maxc), a non-penumbra guide catheter, and a guidewire.It was noted that patient anatomy was tortuous.During the procedure, the physician used a 3maxc, guidewire and guide catheter to bring the jet7 to the target vessel.Next, the physician completed two passes using the jet7.Afterwards, the jet7 was removed and while flushing the jet7 on the back table, it was noticed that approximately three centimeters from the distal tip of the jet7 was damaged.The procedure was completed using a new jet7, the same guide catheter and a stent retriever.There was no report of an adverse effect to the patient.
 
Manufacturer Narrative
Evaluation of the returned jet7 revealed that the catheter was stretched.If the jet7 is forcefully retracted against resistance, damage such as stretching may occur.Further evaluation of the returned jet7 revealed multiple ovalization and kinks throughout the catheter shaft and an ovalized distal tip.This damage was incidental to the reported complaint and likely occurred during packaging of the device for return.Penumbra catheters are visually 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 JET7 REPERFUSION CATHETER
Type of Device
NRY
Manufacturer (Section D)
PENUMBRA, INC.
one penumbra place
alameda CA 94502
MDR Report Key11120712
MDR Text Key225746366
Report Number3005168196-2021-00017
Device Sequence Number1
Product Code NRY
UDI-Device Identifier00815948020962
UDI-Public00815948020962
Combination Product (y/n)Y
PMA/PMN Number
K190010
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup
Report Date 01/01/2005,12/09/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/05/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date02/03/2023
Device Model Number5MAXJET7KIT-B
Device Catalogue Number5MAXJET7KIT
Device Lot NumberF96048
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/11/2021
Was the Report Sent to FDA? Yes
Date Report Sent to FDA01/01/2005
Date Report to Manufacturer01/10/2005
Date Manufacturer Received04/13/2021
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Age60 YR
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