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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: LEMAITRE VASCULAR, INC. TUFTEX OVER-THE-WIRE EMBOLECTOMY CATHETER

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LEMAITRE VASCULAR, INC. TUFTEX OVER-THE-WIRE EMBOLECTOMY CATHETER Back to Search Results
Catalog Number 1651-88
Device Problem Material Rupture (1546)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/09/2024
Event Type  malfunction  
Event Description
During the thrombus removal, the balloon ruptured in the blood vessel.The operation was successfully completed using another catheter.No injury was reported to the patient.
 
Manufacturer Narrative
The device was received for investigation.Inspection of the device observed the balloon ruptured.Due to the nature of the product, balloon ruptures are an expected risk when using this product.As stated in the ifu: as with all catheterization procedures, complications may occur.These may include but are not limited to: infection, local hematomas, intimal disruption, arterial dissection, perforation and rupture, hemorrhage, arterial thrombosis, distal emboli of blood clots or arteriosclerotic plaque, air embolus, aneurysms, arterial spasms, arteriovenous fistula formation, balloon rupture or tip separation with fragmentation and distal embolization.The possibility of balloon rupture must be taken into account when considering the risks involved in the catherization procedure.The lot number of the product was not provided.Therefore, we're unable to perform a lot review.
 
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Brand Name
TUFTEX OVER-THE-WIRE EMBOLECTOMY CATHETER
Type of Device
EMBOLECTOMY CATHETER
Manufacturer (Section D)
LEMAITRE VASCULAR, INC.
63 second ave
burlington MA 01803
Manufacturer (Section G)
LEMAITRE VASCULAR, INC
63 second ave
burlington MA 01803
Manufacturer Contact
peter song
63 second ave
burlington, MA 01803
7814251683
MDR Report Key19075327
MDR Text Key340596427
Report Number1220948-2024-00082
Device Sequence Number1
Product Code DXE
UDI-Device Identifier00840663100750
UDI-Public(01)00840663100750
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K022145
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Company Representative
Reporter Occupation Physician
Type of Report Initial
Report Date 04/09/2024
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 Number1651-88
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/02/2024
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 03/11/2024
Initial Date FDA Received04/09/2024
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
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