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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC IRELAND IN.PACT ADMIRAL PACLITAXEL-ELUTING PTA BALLOON CATHETER; DRUG-ELUTING PERIPHERAL TRANSLUMINAL ANGIOPLASTY CATHETER

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MEDTRONIC IRELAND IN.PACT ADMIRAL PACLITAXEL-ELUTING PTA BALLOON CATHETER; DRUG-ELUTING PERIPHERAL TRANSLUMINAL ANGIOPLASTY CATHETER Back to Search Results
Catalog Number ADM05020013P
Device Problems Leak/Splash (1354); Material Split, Cut or Torn (4008)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Date 01/03/2019
Event Type  malfunction  
Manufacturer Narrative
The in.Pact admiral was returned with no damage visible.The balloon folds were open.A tactile test did not detect any kinks or abnormalities along the length of the catheter.A 0.035 inch guidewire was loaded via the distal tip and passed successfully through the device.Negative prep did detect the presence of a leak.On pressurization of the device a balloon leak was detected.Visual inspection confirmed the presence of a short longitudinal tear between the central markers.The tear was jagged and uneven indicating the balloon material may have been damaged prior to the leak occurring.The balloon could be partially inflated but was unable to maintain pressure.If information is provided in the future, a supplemental report will be issued.
 
Event Description
The physician used a spider fx with a non-medtronic 7 fr sheath, a 0.014 guidewire and an in.Pact admiral dcb to treat a severely calcified lesion with cto (chronic total occlusion 100%) in the mid left popliteal artery.Lesion length and artery diameter were respectively 150 mm and 6 mm.The vessel presented moderate tortuosity.Ifu was followed.Negative prep was performed on the balloon.No leakage was observed.It was reported that difficulty was experienced when pulling the filter into the tip and inserting into the sheath during prep.The spider catheter was delivered over the 0.014 guidewire and then the guidewire was removed as per the ifu.When trying to advance the spider filter through the distal end of the catheter, it would not advance and seemed prolapsed within the delivery system.No detachment occurred.The entire system was then pulled and a new spider was delivered through an.035 non-medtronic wire (glidewire) and a 135 trailblazer.After the system was replaced, the physician progressed with the in.Pact admiral dcb.If u was followed and the device was prepped with no issued identified.An unknown inflation device was used and inflation difficulty was reported at 5 atm.No patient injury reported.These products were replaced with a 7.0 spider fx and a 5 x 200 in.Pact.
 
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Brand Name
IN.PACT ADMIRAL PACLITAXEL-ELUTING PTA BALLOON CATHETER
Type of Device
DRUG-ELUTING PERIPHERAL TRANSLUMINAL ANGIOPLASTY CATHETER
Manufacturer (Section D)
MEDTRONIC IRELAND
parkmore business park west
galway
Manufacturer (Section G)
MEDTRONIC IRELAND
parkmore business park west
galway
Manufacturer Contact
toni o'doherty
parkmore business park west
galway 
091708734
MDR Report Key8517425
MDR Text Key142247843
Report Number9612164-2019-01345
Device Sequence Number1
Product Code ONU
UDI-Device Identifier00643169975019
UDI-Public00643169975019
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P140010
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Reporter Occupation Physician
Type of Report Initial
Report Date 04/16/2019
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 Expiration Date07/03/2021
Device Catalogue NumberADM05020013P
Device Lot Number0009220540
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/29/2019
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 04/10/2019
Initial Date FDA Received04/16/2019
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/04/2018
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage N
Patient Sequence Number1
Patient Age64 YR
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