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U.S. Department of Health and Human Services

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

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BARD PERIPHERAL VASCULAR, INC. VALEO BALLOON EXPANDABLE STENT GRAFT Back to Search Results
Catalog Number EV08181CD
Device Problems Difficult to Insert (1316); Device Dislodged or Dislocated (2923)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 09/29/2023
Event Type  malfunction  
Event Description
It was reported that during preparation for a stent placement procedure, the stent allegedly does not fit into the sheath and failed to advance.It was further reported that the stent was allegedly shearing off from the balloon when inserted into the sheath.The procedure was completed using another device.There was no patient contact.
 
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 valeo device was received for evaluation.The stent was noted to be dislodged from the balloon.Functional testing with the introducer sheath could not be performed due to the condition of the returned device.Therefore, the investigation is inconclusive for the reported sheath insertion difficulty, but confirmed for the reported stent dislodgement, as functional testing using the sheath could not be performed per the conditions of use since the device was received with the stent dislodged from the balloon.A definitive root cause for the alleged sheath insertion difficulty and stent dislodgement 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: (expiration date: 02/2025).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.
 
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Brand Name
VALEO BALLOON EXPANDABLE STENT GRAFT
Type of Device
BALLOON EXPANDABLE STENT
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe 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 Key18683150
MDR Text Key335206693
Report Number2020394-2024-00190
Device Sequence Number1
Product Code FGE
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
Report Date 02/01/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/12/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberEV08181CD
Device Lot NumberGFHN2337
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/06/2023
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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