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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. ATLAS GOLD; PTA BALLOON DILATATION CATHETER

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BARD PERIPHERAL VASCULAR, INC. ATLAS GOLD; PTA BALLOON DILATATION CATHETER Back to Search Results
Model Number ATG80142
Device Problems Break (1069); Inflation Problem (1310); Difficult to Remove (1528); Unraveled Material (1664); Detachment of Device or Device Component (2907); Material Deformation (2976)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/10/2023
Event Type  malfunction  
Manufacturer Narrative
As the lot number for the device was provided, a review of the device history records is currently being performed.The device has been returned to the manufacturer for evaluation.The investigation of the reported event is currently underway.(expiry date: 12/2025).
 
Event Description
It was reported that during an angioplasty procedure, the pta balloon allegedly failed to inflate and had difficulty in retracting the device from the sheath.It was further reported that the balloon was shaped weird and allegedly detached.Reportedly, the device had some hair strings around the balloon.There was no reported patent injury.
 
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 atlas gold pta dilatation catheter was received for evaluation.During visual evaluation, the balloon was observed to be inverted with unraveling fibers, and detached from the catheter but still attached to the inner guidewire lumen that was completely exposed.The glue bullet was not seated in the correct position and marker bands were still present.No anomalies noted to the luers/y-body.No functional testing was performed due to the condition of the sample.Therefore, the investigation is confirmed for the reported unraveled material as unraveling fibers were noted on the device.The investigation is also confirmed for the identified break as the balloon was seen detached from the catheter at one end but still attached to the inner guidewire lumen.The investigation is also confirmed for the removal difficulty as the balloon was observed to be inverted, which would have occurred due to difficulty removing through the sheath.The investigation is inconclusive for the reported uneven inflation as no functional testing could be performed due to the condition of the returned device.The investigation is unconfirmed for the reported detachment as no complete detachment was noted on the device.A definitive root cause for the alleged uneven inflation, removal difficulty, unraveled material, detachment and identified break could not be determined based upon the provided information.Labeling review: a review of product labeling documentation (e.G., procedural instructions, indications, warnings, precautions, cautions, possible complications, contraindications, nursing guide, and unit label) did not find any product labeling inadequacy.The information provide 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.
 
Event Description
It was reported that during an angioplasty procedure, the pta balloon allegedly did not expand and the shape of the balloon was weird.It was further reported that there was difficulty in retracting the device thru the introducer sheath.Reportedly, the balloon allegedly detached and hair strings was noted around the balloon.There was no reported patent injury.
 
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 atlas gold pta dilatation catheter was received for evaluation.During visual evaluation, the balloon was observed to be inverted with unraveling fibers, and detached from the catheter but still attached to the inner guidewire lumen that was completely exposed.The glue bullet was not seated in the correct position and marker bands were still present.No anomalies noted to the luers/y-body.No functional testing was performed due to the condition of the sample.Therefore, the investigation is confirmed for the reported unraveled material as unraveling fibers were noted on the device.The investigation is also confirmed for the identified break as the balloon was seen detached from the catheter at one end but still attached to the inner guidewire lumen.However, the investigation is inconclusive for the reported uneven inflation and removal difficulty as no functional testing could be performed due to the condition of the returned device.Additionally, the investigation is unconfirmed for the reported detachment as no complete detachment was noted on the device.A definitive root cause for the alleged uneven inflation, removal difficulty, unraveled material, detachment and identified break could not be determined based upon the provided information.Labeling review: a review of product labeling documentation (e.G., procedural instructions, indications, warnings, precautions, cautions, possible complications, contraindications, nursing guide, and unit label) did not find any product labeling inadequacy.H10: d4 (expiry date: 12/2025), g3, h6 (device, method).H11: section a through f ¿ the information provide 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.
 
Event Description
It was reported that during an angioplasty procedure, the pta balloon allegedly did not expand and the shape of the balloon was weird.It was further reported that there was difficulty in retracting the device thru the introducer sheath.Reportedly, the balloon allegedly detached and hair strings was noted around the balloon.There was no reported patent injury.
 
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Brand Name
ATLAS GOLD
Type of Device
PTA BALLOON DILATATION CATHETER
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
FUTUREMATRIX INTERVENTIONAL
1605 enterprise street
athens 75751
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key16483443
MDR Text Key310855172
Report Number2020394-2023-00139
Device Sequence Number1
Product Code DQY
UDI-Device Identifier00801741060731
UDI-Public(01)00801741060731
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K181323
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,Followup,Followup
Report Date 06/06/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberATG80142
Device Catalogue NumberATG80142
Device Lot Number93ZG0093
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/22/2023
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/06/2023
Initial Date FDA Received03/04/2023
Supplement Dates Manufacturer Received03/16/2023
06/06/2023
Supplement Dates FDA Received04/01/2023
06/10/2023
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
Patient SexFemale
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