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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOTRONIK AG, BUELACH, SWITZERLAND PASSEO-18 5/60/90; PERIPHERAL DILATATION CATHETER

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BIOTRONIK AG, BUELACH, SWITZERLAND PASSEO-18 5/60/90; PERIPHERAL DILATATION CATHETER Back to Search Results
Model Number 357466
Device Problem Fluid/Blood Leak (1250)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 06/19/2023
Event Type  malfunction  
Event Description
The passeo-18 balloon catheter was chosen for treatment of a moderately calcified lesion with 90 percent stenosis degree in the moderately tortuous distal brachial artery.During attempt to inflate the balloon, the pressure was not maintained and the balloon was deflated.
 
Manufacturer Narrative
The returned product was subjected to a technical analysis and the corresponding product release documentation was reviewed to establish whether a deviation from the manufacturing process could be the cause for this event.The technical investigation of the complaint instrument confirmed that the balloon has not been inflated and was returned in a slightly unfolded state.After introduction of a 0.018 inch reference guidewire, functional testing was performed by successfully inflating the balloon with up to 15 atm (rbp).Microscopic inspection of the balloon surface revealed no damage, irregularity, or leakage.Review of the product release documentation confirmed that the instrument was manufactured according to specifications and passed all in-process and final inspections.In addition to visual inspections each instrument is tested for air tightness by means of a pressure test and a helium leakage test.We can therefore confirm that the instrument was delivered in a leak-proof condition.Based on the conducted investigations of the device being subject to this complaint, we can confirm that no product failure could be determined.
 
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Brand Name
PASSEO-18 5/60/90
Type of Device
PERIPHERAL DILATATION CATHETER
Manufacturer (Section D)
BIOTRONIK AG, BUELACH, SWITZERLAND
ackerstrasse 6
buelach CH-81 80
CH  CH-8180
Manufacturer Contact
6024 jean road
lake oswego, OR 97035
8772459800
MDR Report Key17298490
MDR Text Key318777947
Report Number1028232-2023-03459
Device Sequence Number1
Product Code LIT
UDI-Device Identifier07640119558776
UDI-Public(01)07640119558776(17)2411
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
K072765
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility,Company Representative
Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date 08/09/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received07/11/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number357466
Device Catalogue NumberSEE MODEL NO.
Device Lot Number11216211
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/26/2023
Is the Reporter a Health Professional? Yes
Date Manufacturer Received08/09/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured12/13/2021
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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