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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PENUMBRA, INC. BENCHMARK 6F 071 DELIVERY CATHETER; DQY, QJP

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PENUMBRA, INC. BENCHMARK 6F 071 DELIVERY CATHETER; DQY, QJP Back to Search Results
Catalog Number BMK6F95BER120
Device Problems Break (1069); Leak/Splash (1354)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/19/2023
Event Type  malfunction  
Manufacturer Narrative
Evaluation of the returned benchmark confirmed that the catheter was damaged on its proximal end and was leaking.Evaluation revealed a kink on the proximal end of the catheter near the hub, and a hole was present underneath the strain relief.If the device is handled at an angle during use, damage such as this may occur.Further evaluation revealed bends and ovalizations along the catheter shaft.This damage was not mentioned in the complaint and is likely incidental and may have occurred during packaging for return to penumbra.Penumbra catheters are inspected during in-process inspection and during quality inspection after manufacturing.The manufacturing records for this lot were reviewed and did not reveal any outstanding discrepancies, design, or quality concerns.
 
Event Description
The patient was undergoing a medical procedure using a benchmark 6f 071 delivery catheter (benchmark) and a non-penumbra sheath.During the procedure, the physician advanced the benchmark to the target location and noticed that the benchmark was damaged at the proximal end.It was reported that the benchmark was leaking at the hub.Therefore, the benchmark was removed.The procedure was completed using another benchmark and the same sheath.There was no report of an adverse effect to the patient.
 
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Brand Name
BENCHMARK 6F 071 DELIVERY CATHETER
Type of Device
DQY, QJP
Manufacturer (Section D)
PENUMBRA, INC.
one penumbra place
alameda CA 94502
Manufacturer Contact
veronica farris
one penumbra place
alameda, CA 94502
5107483200
MDR Report Key18545238
MDR Text Key333269659
Report Number3005168196-2024-00029
Device Sequence Number1
Product Code DQY
UDI-Device Identifier00814548014128
UDI-Public814548014128
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K212838
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 01/01/2005,01/19/2024
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 Catalogue NumberBMK6F95BER120
Device Lot NumberF111286
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/29/2023
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? Yes
Date Report Sent to FDA01/01/2005
Date Report to Manufacturer01/10/2005
Initial Date Manufacturer Received 12/26/2023
Initial Date FDA Received01/19/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured12/07/2021
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 Age68 YR
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