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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. TREK BONE LESION BIOPSY KIT; BIOPSY INSTRUMENT

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BARD PERIPHERAL VASCULAR, INC. TREK BONE LESION BIOPSY KIT; BIOPSY INSTRUMENT Back to Search Results
Catalog Number TKL1110
Device Problems Device Contamination with Chemical or Other Material (2944); Unintended Movement (3026)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 08/30/2023
Event Type  malfunction  
Manufacturer Narrative
H10: manufacturing review: a manufacturing review was not requested as the lot number reported is unknown.Investigation summary: one quick connect hub was received for evaluation.Upon visual evaluation and microscopic visual observation, the device appeared to have black residue in the inner side of the connect hub.There were no visual anomalies noted on the device.And it was noted that the proximal u-clip was not visible within the quick connect hub.Therefore, the investigation is confirmed for the reported unintended movement issue as the device was received with u-clips not visible.And the investigation is confirmed for the identified device contamination with chemical or other material issue as the black residue was noted in the inner side of the connect hub.A definitive root cause for the reported unintended movement issue was due to the u-clip was not visible.Then, definitive root cause for the identified device contamination with chemical or other material issues 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.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 a femur biopsy procedure, the quick connect hub had allegedly started to wobble and lost the rpm's about fifteen seconds into drilling.It was further reported that another two sleeves were opened, and both had the same issue after about the same amount of drilling.The procedure was completed by using another device.There was no reported patient injury.
 
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Brand Name
TREK BONE LESION BIOPSY KIT
Type of Device
BIOPSY INSTRUMENT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
CAREFUSION MANNFORD
400 foster rd
mannford OK 74044
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key18607499
MDR Text Key334186262
Report Number2020394-2024-00139
Device Sequence Number1
Product Code KNW
UDI-Device Identifier00801741201455
UDI-Public(01)00801741201455
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K213896
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
Report Date 01/22/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/30/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberTKL1110
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/27/2023
Is the Reporter a Health Professional? Yes
Date Manufacturer Received01/29/2024
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
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