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U.S. Department of Health and Human Services

Class 2 Device Recall Vaxcel PICC with PASV Valve Technology

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 Class 2 Device Recall Vaxcel PICC with PASV Valve Technologysee related information
Date Initiated by FirmNovember 22, 2004
Date PostedJanuary 20, 2005
Recall Status1 Terminated 3 on December 16, 2005
Recall NumberZ-0409-05
Recall Event ID 30572
510(K)NumberK021704 
Product Classification Catheter, Intravascular, Therapeutic, Long-Term Greater Than 30 Days - Product Code LJS
ProductVAXCEL WITH PASV PICC, 3F, single lumen. CUSTOM KIT - UNIVERSITY OF NEW MEXICO HOSPITAL, Catalog # 60M210624, UPN #M00160M2106240. Firm on label: Boston Scientific Corp, NAMIC Technology Center, 10 Glens Falls Technical Park, Glens Falls, NY . DEVICE DESCRIPTION: Each kit contains a radiopaque, polyurethane catheter with a hub/suture wing, polyurethane extension leg(s) and luer locking adapter(s). A peel away sheath introducer allows for percutaneous insertion of the catheter. The hub/suture wing promotes fixation of the catheter hub to the patient''s skin.
Code Information 909873; 910390; 910849; 964847; 966372; 969263; 972284; 973904;
FEI Number 3001451463
Recalling Firm/
Manufacturer		 Boston Scientific Corporation
1 Boston Scientific Pl
Natick MA 01760-1536
For Additional Information ContactMarie Peters
508-652-5875
Manufacturer Reason
for Recall		Catheter separation immediately distal to the nose of the suture wing.
FDA Determined
Cause 2		Other
ActionLetters dated 11/22/2004 issued via Certified Mail. Customers instructed to return units in inventory. Patients with implanted units are to be evaluated.
Quantity in Commerce 68 kits
Distribution75 hospitals and medical centers throughout the U.S. One foreign consignee, a hospital in New Brunswick, Canada.
Total Product Life CycleTPLC Device Report
1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
510(K) Database510(K)s with Product Code = LJS
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