Catalog Number VBCR070202A |
Device Problem
Material Fragmentation (1261)
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Patient Problem
No Consequences Or Impact To Patient (2199)
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Event Date 10/24/2018 |
Event Type
malfunction
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Manufacturer Narrative
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Concomitant medical product: 8fr vascular sheath.A review of the manufacturing records for the device is currently in progress.(b)(4).
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Event Description
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The following information was reported to gore: in a voluntarily submitted medwatch, it states the following: on (b)(6) 2018, a patient was undergoing fistulogram treatment with thrombectomy and angioplasty with stent graft deployment of a left arm hemodialysis graft.After the arterial plug and residual thrombus were removed, there was still a residual stenosis across the venous anastomosis.A gore® viabahn® endoprosthesis was advanced over a.035" guidewire to treat this stenosis.Following deployment, upon removal of the delivery catheter, it was noticed that the distal end of the catheter was missing.Fluoroscopy revealed that the fractured tip was still on the guidewire.The tip was able to be retrieved successfully.
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Manufacturer Narrative
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Conclusion code 2: updated.
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Manufacturer Narrative
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H.6.Results code 2: 213: the engineering evaluation stated the following: the following observations were made: only the delivery catheter was returned.The endoprosthesis, deployment knob, and deployment line were not returned.The distal tip bonded to the distal shaft, upon which the endoprosthesis was mounted, was separated from the transition and dual lumen.The transition end of the distal shaft did not appear to have an interruption in the pebax material.The distal shaft measured approximately 3.9 cm.The expected distal shaft length for this size device is 4.35 to 5.15 cm.The transition appears bonded to the dual lumen catheter shaft.Based on the device examination performed, anomalies were identified that could potentially be attributed to manufacturing.
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Manufacturer Narrative
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D.10.Updated e.1.Updated h.3.Updated.
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Manufacturer Narrative
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H.6.Results code 1: 213: a review of the manufacturing records for the device verified the lot met all pre-release specifications.
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Search Alerts/Recalls
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