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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. VALEO; BALLOON EXPANDABLE BILIARY STENT

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BARD PERIPHERAL VASCULAR, INC. VALEO; BALLOON EXPANDABLE BILIARY STENT Back to Search Results
Catalog Number EV08262CD
Device Problems Difficult to Insert (1316); Device Dislodged or Dislocated (2923); Material Deformation (2976)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 06/28/2023
Event Type  malfunction  
Event Description
It was reported that during an angioplasty procedure in the external iliac artery via the common femoral artery, the stent allegedly got caught in valve of sheath when tried to advance.It was further reported that the stent was not very tight on the balloon either and slid off way too easy.The procedure was completed using another device.There was no reported patient injury.
 
Manufacturer Narrative
H10: as the lot number for the device was provided, a review of the device history records is currently being performed.The device has not been returned to the manufacturer for evaluation.However, a photo was provided for review.The investigation of the reported event is currently underway.H10: d4 (expiration date: 10/2024).H11: section a through f ¿ the information provided by bd represents all 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 bd.H3 other text : device not returned.
 
Manufacturer Narrative
H10: manufacturing review: a manufacturing review was not required as this is the only complaint reported to date for this product and lot.Investigation summary: the physical device was not returned for evaluation.One photo was provided and reviewed.The photo shows the valeo balloon deflated and bloody.The stent is seen deformed and dislodged from the balloon.No other anomalies noted.Therefore, the investigation is confirmed for the reported stent dislodgement and identified stent deformation as the stent is seen deformed and dislodged from the balloon.However, the investigation is inconclusive for the reported sheath insertion difficulty as functional testing for the same could not be performed due to the condition of the device.A definitive root cause for the alleged sheath insertion difficulty, stent dislodgement and identified stent deformation could not be determined based upon the provided information.Labeling review: a review of product labeling documentation (e.G., procedural instructions, indications, warnings, precautions, cautions, possible complications, contraindications, nursing guide, and unit label) did not find any product labeling inadequacy.H10: d4 (expiration date: 10/2024).H11: section a through f ¿ the information provided by bd represents all 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 bd.H3 other text : device not returned.
 
Event Description
It was reported that during an angioplasty procedure in the external iliac artery via the common femoral artery, the stent allegedly got caught in valve of sheath when tried to advance.It was further reported that the stent was not very tight on the balloon either and slid off way too easy.The procedure was completed using another device.There was no reported patient injury.
 
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Brand Name
VALEO
Type of Device
BALLOON EXPANDABLE BILIARY STENT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
C.R. BARD, INC. (GFO)
289 bay road
queensbury 12804
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key17765296
MDR Text Key324025505
Report Number2020394-2023-00697
Device Sequence Number1
Product Code FGE
UDI-Device Identifier00801741000829
UDI-Public(01)00801741000829
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K052132
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Health Professional,User Facility,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 09/26/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/18/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberEV08262CD
Device Lot NumberGFGW1495
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received09/25/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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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