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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. DENALI FILTER SYSTEM; VENA CAVA FILTER

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BARD PERIPHERAL VASCULAR, INC. DENALI FILTER SYSTEM; VENA CAVA FILTER Back to Search Results
Catalog Number UNK DENALI
Device Problem Detachment of Device or Device Component (2907)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 07/01/2016
Event Type  malfunction  
Manufacturer Narrative
H10: (b)(6), (2016).Bard denali filter fractures.Journal of vascular and interventional radiology, 27(7):1099-101.Doi: 10.1016/j.Jvir.2016.04.008.H10: as the lot number for the device was not provided, a review of the device history records could not be performed.The device has not been returned to the manufacturer for evaluation.However, images were provided for review.The investigation of the reported event is currently underway.H11: section a through f - the information provided by bd represents all of 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 in an article titled "bard denali filter fractures", that a inferior vena cava filter was deployed successfully, in a patient with left lower extremity deep venous thrombus with subsequent retroperitoneal hemorrhage while anticoagulated.Approximately two hundred and forty two days later post filter deployment, the filter strut detached during retrieval of the filter.It was further reported that the detached strut and filter were successfully retrieved with combination snare for the filter and forceps for the fractured strut.There was no reported patient injury.
 
Manufacturer Narrative
Manufacturing review: a manufacturing review was not requested as the lot number reported is unknown.Investigation summary: the physical device was not returned for evaluation.No photos were provided for review.Therefore, the investigation is inconclusive for the reported failure as no objective evidence was provided for review.A definitive root cause for the detachment could not be determined based upon the provided information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.Bill s.Majdalany, minhajuddin s.Khaja, and david m.Williams, (2016).Bard denali filter fractures.Journal of vascular and interventional radiology, 27(7): 1099-1101.Doi: 10.1016/j.Jvir.2016.04.008.The information provided 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 in an article in the "journal of vascular and interventional radiology" titled "bard denali filter fractures", that an inferior vena cava filter was deployed successfully in a patient after being diagnosed with left lower extremity deep venous thrombus with subsequent retroperitoneal hemorrhage.Approximately two hundred and forty-two days post a vena cava filter deployment, the filter strut had allegedly detached within a centered filter during retrieval of the filter.Reportedly, the detached filter strut and filter were successfully retrieved with combination of a conventional snare for the filter and forceps for the fractured strut.There was no reported patient injury.
 
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Brand Name
DENALI FILTER SYSTEM
Type of Device
VENA CAVA FILTER
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
C.R. BARD, INC. (GFO)
289 bay road
queensbury 12804
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key19030292
MDR Text Key339234165
Report Number2020394-2024-00430
Device Sequence Number1
Product Code DTK
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K130366
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Literature
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 05/08/2024
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 NumberUNK DENALI
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/07/2024
Initial Date FDA Received04/03/2024
Supplement Dates Manufacturer Received05/08/2024
Supplement Dates FDA Received05/13/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
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 Age65 YR
Patient SexFemale
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