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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. CONQUEST 40; PTA BALLOON DILATATION CATHETER

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BARD PERIPHERAL VASCULAR, INC. CONQUEST 40; PTA BALLOON DILATATION CATHETER Back to Search Results
Catalog Number CQF7576
Device Problems Material Frayed (1262); Difficult to Remove (1528); Material Rupture (1546)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 11/29/2023
Event Type  malfunction  
Manufacturer Narrative
H10: as the lot number for the device was provided, a review of the device history records will be performed.The return of the sample is pending.The investigation of the reported event is currently underway.H10: d4 (expiry date: 02/2026).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.
 
Event Description
It was reported that during an angioplasty procedure, the pta balloon allegedly ruptured at 20-25 atm.It was further reported that pta balloon was allegedly difficult to be removed from the sheath.The procedure was completed by using another device.There was no reported patient injury.
 
Event Description
It was reported that during an angioplasty procedure to treat a forearm loop graft, the pta balloon allegedly ruptured longitudinal within the loop graft after the second to third inflation to 20-25 atms with a 3cc syringe.It was further reported that the balloon was allegedly difficult to remove from the sheath.The thrombectomy procedure was completed by using another device.There was no reported patient injury.
 
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: one conquest 40 pta dilatation catheter was returned for evaluation.The sample appeared to have residue throughout.Fraying and fiber disturbance were noted to the balloon.A partial compound rupture was also noted to the balloon.An in-house syringe was used to flush the in-house introducer sheath without any issues.The patency of the guidewire lumen was then tested using an in-house guidewire and was able to be inserted without issues.An attempt was made to insert the balloon through the introducer sheath but was unsuccessful.No other functional testing performed.Therefore, the investigation is confirmed for the reported balloon rupture as a compound rupture was noted to the balloon.However, the investigation is inconclusive for the reported difficulty removing from sheath as functional testing for it could not be performed due to the condition of the device.The investigation is also confirmed for the identified fraying of fibers as fraying and fiber disturbance were observed to the balloon.A definitive root cause for the reported balloon rupture, difficulty removing from sheath and identified fraying of fibers could not be determined based upon the provided information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.H10: d4 (expiry date: 02/2026), g3, h6 (device) h11: b5, h6 (method, result, conclusion) 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 : see h10.
 
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Brand Name
CONQUEST 40
Type of Device
PTA BALLOON DILATATION CATHETER
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
BARD REYNOSA S.A. DE C.V. -9617592
blvd. montebello #1
parque industrial colonial
reynosa, tamaulipas 88780
MX   88780
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key18366820
MDR Text Key331313275
Report Number2020394-2023-01298
Device Sequence Number1
Product Code DQY
UDI-Device Identifier00801741060502
UDI-Public(01)00801741060502
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K120660
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 03/04/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/20/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberCQF7576
Device Lot NumberREHQ4610
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Date Manufacturer Received03/01/2024
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Age64 YR
Patient SexFemale
Patient RaceWhite
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