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Model Number 1584-01 |
Device Problems
Deflation Problem (1149); Adverse Event Without Identified Device or Use Problem (2993)
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Patient Problems
Hemorrhage/Bleeding (1888); Perforation of Vessels (2135); Obstruction/Occlusion (2422)
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Event Date 07/15/2021 |
Event Type
Injury
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Event Description
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It was reported that vessel occlusion and vessel damage occurred.The 80% stenosed target vessel was located in the moderately calcified and mildly tortuous anterior tibial artery.Pre-dilation was successfully performed with a 2.0 x 150 sterling balloon catheter.Then, a 2.5 x 150 ranger sl drug-coated balloon was advanced and inflated to 6 atmospheres for 3 minutes.When attempting to deflate the balloon, the balloon would not deflate.Several methods to deflate the balloon were tried, including changing the inflation device, using a 60ml syringe and a three way stop-cock, all without success.After 15 minutes, the balloon was withdrawn while inflated and the procedure was terminated.Angiographic imaging showed slow blood flow in the anterior tibial artery and injury to the inner layer of the vessel.The patient received anticoagulation medication.No further patient complications were reported.The patient is in stable condition.
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Manufacturer Narrative
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H3 - device evaluated by manufacturer: returned product consisted of a ranger sl drug coated balloon catheter.The outer shaft, inner shaft, balloon and tip were visually and microscopically examined.Visual examination revealed multiple stretched sections to the inflation lumen.The guidewire lumen is separated 149.5cm from the hub and 18.5cm from the tip.The guidewire lumen is wavy distal of the separation and the balloon is partially pulled over the tip.There are multiple kinks to the inflation lumen.The balloon protector was not removed and is sitting on the inflation lumen.Microscopic examination revealed that the tip is damaged.Inspection of the remainder of the device presented no other damage or irregularities.
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Event Description
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It was reported that vessel occlusion and vessel damage occurred.The 80% stenosed target vessel was located in the moderately calcified and mildly tortuous anterior tibial artery.Pre-dilation was successfully performed with a 2.0 x 150 sterling balloon catheter.Then, a 2.5 x 150 ranger sl drug-coated balloon was advanced and inflated to 6 atmospheres for 3 minutes.When attempting to deflate the balloon, the balloon would not deflate.Several methods to deflate the balloon were tried, including changing the inflation device, using a 60ml syringe and a three way stop-cock, all without success.After 15 minutes, the balloon was withdrawn while inflated and the procedure was terminated.Angiographic imaging showed slow blood flow in the anterior tibial artery and injury to the inner layer of the vessel.The patient received anticoagulation medication.No further patient complications were reported.The patient is in stable condition.It was further reported that blood loss occurred, however, the amount lost was insignificant.
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Search Alerts/Recalls
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