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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PHILIPS VOLCANO PIONEER PLUS PPLUS120; CATHETER FOR CROSSING TOTAL OCCLUSIONS

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PHILIPS VOLCANO PIONEER PLUS PPLUS120; CATHETER FOR CROSSING TOTAL OCCLUSIONS Back to Search Results
Model Number PPLUS120
Medical Device Problem Code Sharp Edges (4013)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/10/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This complaint was reviewed and investigated according to the manufacturer¿s policy.The pioneer plus pplus120 was not returned for evaluation, thus no returned product investigation was performed.Submission of this report does not, in itself, represent a conclusion by the manufacturer and/or authorized representative or the national competent authority that the content of this report is complete or accurate, that the medical device(s) listed failed in any manner and/or that the medical device(s) caused or contributed to an alleged death or deterioration in the state of the health of any person.
 
Event or Problem Description
It was reported that a pioneer plus pplus120 catheter was used in a therapeutic peripheral procedure to treat a severely calcified sfa.After successfully re-entering the true lumen, the catheter became stuck and the needle was unable to retract.The catheter was able to be removed with the exposed needle, with no patient injury reported.The case was completed with other non-philips devices.  this product problem is being submitted due to the exposed needle, resulting in a sharp edge.There is a potential for harm if the malfunction were to reoccur.
 
Additional Manufacturer Narrative
Block h3: the pioneer plus pplus120 catheter was returned for evaluation.Visual and microscopic inspection confirmed the needle was deployed out of the exit port, resulting in a sharp edge of non-malleable material.Block h6: the probable cause is a mechanical failure due to the needle unable to retract.Device manipulation, impact and applied pressure associated with use and handling may affect the integrity of the device.Submission of this report does not, in itself, represent a conclusion by the manufacturer and/or authorized representative or the national competent authority that the content of this report is complete or accurate, that the medical device(s) listed failed in any manner and/or that the medical device(s) caused or contributed to an alleged death or deterioration in the state of the health of any person.
 
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Brand Name
PIONEER PLUS PPLUS120
Common Device Name
CATHETER FOR CROSSING TOTAL OCCLUSIONS
Manufacturer (Section D)
PHILIPS VOLCANO
3721 valley centre drive #500
san diego CA 92130
Manufacturer (Section G)
VOLCARICA S.R.L.
coyol free zone &business park
b37
alajuela
CS  
Manufacturer Contact
ana tan
3721 valley centre drive #500
san diego, CA 92130
510673-2239
MDR Report Key16527145
Report Number3008363989-2023-00009
Device Sequence Number5246190
Product Code PDU
UDI-Device Identifier00845225002565
UDI-Public(01)00845225002565(11)220818(17)240818(10)5419416
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K162418
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 04/26/2023
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 Date08/18/2024
Device Model NumberPPLUS120
Device Catalogue Number400-0200.246
Device Lot Number5419416
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer Not provided
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date03/10/2023
Supplement Report FDA Received Date04/26/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/18/2022
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
UNK MFG AND SIZE: GUIDE CATHETER; UNK MFG AND SIZE: GUIDEWIRE; UNK MFG AND SIZE: INTRODUCER SHEATH
Patient SexUnknown
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