MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION GLADIATOR ELITE; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL

Model Number	24686
Medical Device Problem Code	Material Rupture (1546)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	02/24/2022
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that balloon rupture occurred.The target lesion was located in an arteriovenous fistula in the left upper limb.A 5.0 x40, 75cm gladiator balloon catheter was advanced for dilation.The device was inflated twice, however, when the pressure pump hit 22 atmospheres, the balloon ruptured.The device was removed, and the procedure was completed with another of same device.There were no patient complications reported and the patient was stable.
Event or Problem Description
It was reported that balloon rupture occurred.The target lesion was located in an arteriovenous fistula in the left upper limb.A 5.0 x40, 75cm gladiator balloon catheter was advanced for dilation.The device was inflated twice, however, when the pressure pump hit 22 atmospheres, the balloon ruptured.The device was removed, and the procedure was completed with another of same device.There were no patient complications reported and the patient was stable.It was further reported that the lesion has stenosis and the balloon ruptured during the first inflation for 22 seconds.
Additional Manufacturer Narrative
Gladiator elite 5.0 x40, 75cm was received for analysis.A visual examination identified that the balloon was not folded which indicates that the balloon was subjected to positive pressure.A partial balloon circumferential tear was identified located approximately 3mm proximal of the distal markerband.The balloon material was also torn longitudinally beginning at the circumferential tear and extending for approximately 5mm proximally.No other issues were noted with the balloon material.As per gladiator specification, the rated burst pressure for this device is 24 atmospheres.A visual examination observed no damage to tip of the device.A visual and tactile examination found no kinks or damage to the shaft of the device.Both markerbands were undamaged and present on the shaft of the device.
Event or Problem Description
It was reported that balloon rupture occurred.The target lesion was located in an arteriovenous fistula in the left upper limb.A 5.0 x40, 75cm gladiator balloon catheter was advanced for dilation.The device was inflated twice, however, when the pressure pump hit 22 atmospheres, the balloon ruptured.The device was removed, and the procedure was completed with another of same device.There were no patient complications reported and the patient was stable.It was further reported that the lesion has stenosis and the balloon ruptured during the first inflation for 22 seconds.

• Brand Name: GLADIATOR ELITE
• Common Device Name: CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL
• Manufacturer (Section D): BOSTON SCIENTIFIC CORPORATION; two scimed place; maple grove MN 55311
• Manufacturer (Section G): BOSTON SCIENTIFIC CORPORATION; pmt 741 persiaran cassia selat; bandarcassia, pulau pinan 14110 ; MY 14110
• Manufacturer Contact: jay johnson ; two scimed place; maple grove, MN 55311 ; 7634942574
• MDR Report Key: 13709093
• Report Number: 2134265-2022-02634
• Device Sequence Number: 5448431
• Product Code: LIT
• UDI-Device Identifier: 08714729809678
• UDI-Public: 08714729809678
• Combination Product (Y/N): N
• Initial Reporter Country: CH
• PMA/510(K) Number: K132810
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,Company Representative,Distributor
• Initial Reporter Occupation: Physician
• Type of Report: Initial,Followup,Followup
• Report Date (Section B): 04/05/2022

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
• Operator of Device: Health Professional
• Device Expiration Date: 06/22/2024
• Device Model Number: 24686
• Device Catalogue Number: 24686
• Device Lot Number: 0027545608
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 02/28/2022
• Supplement Date Received by Manufacturer: 03/09/2022; 03/29/2022
• Initial Report FDA Received Date: 03/09/2022
• Supplement Report FDA Received Date: 03/15/2022; 04/05/2022
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 06/23/2021
• Is the Device Labeled for Single Use? (Y/N): Yes
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Age: 70 YR
• Patient Sex: Female
• Patient Weight: 57 KG