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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOTRONIK AG, BUELACH, SWITZERLAND PULSAR-18 T3 4/30/135; STENT, SUPERFICIAL FEMORAL ARTERY

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BIOTRONIK AG, BUELACH, SWITZERLAND PULSAR-18 T3 4/30/135; STENT, SUPERFICIAL FEMORAL ARTERY Back to Search Results
Model Number 430478
Device Problem Activation Failure (3270)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/20/2024
Event Type  malfunction  
Event Description
A pulsar-18 self-expandable stent system was selected for treatment.The device was inserted into the patient, but the stent was not deployed as the deployment mechanism did not work.The catheter was removed.The system was discarded.
 
Manufacturer Narrative
Neither the affected device nor the angiographic material was returned.Therefore, no technical investigation on the subject could be performed.The production documentation was reviewed to establish whether a deviation from the manufacturing process could be the cause for the reported event.Review of the production for the product detailed above confirmed that the instrument was manufactured according to specifications and fulfilled all the requirements of in-process and final inspection.Based on the conducted investigations, no material or manufacturing related root cause could be determined.
 
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Brand Name
PULSAR-18 T3 4/30/135
Type of Device
STENT, SUPERFICIAL FEMORAL ARTERY
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 Key18960710
MDR Text Key338760217
Report Number1028232-2024-01601
Device Sequence Number1
Product Code NIP
UDI-Device Identifier07640130446762
UDI-Public(01)07640130446762(17)2502
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
P160025
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 04/16/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/22/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number430478
Device Catalogue NumberSEE MODEL NO.
Device Lot Number02220959
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received04/16/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/16/2022
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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