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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. ENCOR NEEDLE GUIDE INSERT; DISPOSABLE BIOPSY

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BARD PERIPHERAL VASCULAR, INC. ENCOR NEEDLE GUIDE INSERT; DISPOSABLE BIOPSY Back to Search Results
Catalog Number ENCFINSERT10G
Medical Device Problem Codes Accessory Incompatible (1004); Difficult to Remove (1528)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/04/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
As the lot number for the device was provided, a review of the device history records is currently being performed.The return of the sample is pending.The investigation of the reported event is currently underway.(expiry date: 04/2024).Section a through f: the information provide 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.H3 other text : device pending return.
 
Event or Problem Description
It was reported that during a stereotactic breast biopsy procedure through normal density tissue, the needle guide was allegedly too tight and took so long to remove the needle.There was no reported patient injury.
 
Additional Manufacturer Narrative
H10: manufacturing review: the device history records have been reviewed and this lot met all release criteria.There was nothing found to indicate there was a manufacturing related cause for this event.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 alleged accessory incompatible and difficult to remove issues 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.H10: d4 (expiry date: 04/2024), g3, h6 (method).H11: h6 (result, conclusion).H11: section a through f: the information provide 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 or Problem Description
It was reported that during a stereotactic breast biopsy procedure through normal density tissue, the needle guide was allegedly too tight and took so long to remove the needle.There was no reported patient injury.
 
Event or Problem Description
It was reported that during a stereotactic breast biopsy procedure through normal density tissue, the needle guide was allegedly too tight and took so long to remove the needle.It was further reported that the needle guide was too small.There was no reported patient injury.
 
Additional Manufacturer Narrative
H10: manufacturing review: the device history records have been reviewed and this lot met all release criteria.There was nothing found to indicate there was a manufacturing related cause for this event.Investigation summary: received one unsealed and twelve sealed encor needle guide inserts were returned for evaluation.Since, original sample was returned along with, the sealed lot samples; the returned sealed samples will not be evaluated.On visual evaluation, the needle guide insert appeared to be clean and flash was noted within the inner surface.There were no other visual anomalies noted on the device.On functional evaluation, the encor needle guide insert was loaded onto an in-house 10g encor probe needle.Resistance was noted when loading the insert onto the needle, and could not be completely loaded onto the needle.On dimensional observation, the inner diameter was measured and measurement was noted to be not within the acceptable range.Therefore, the investigation is confirmed for the reported accessory incompatible issue as the resistance was noted when loading & removing the insert from the needle and the inner diameter was measured and measurement was noted to be not within the acceptable range.And, the investigation is inconclusive for the reported difficult to remove issue as the condition of use cannot be replicated at the laboratory.The definitive root cause for the alleged accessory incompatible issue was determined to be a manufacturing issue.And, the definitive root cause for the alleged difficult to remove issue 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.The information provide 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.H3 other text : see h10.
 
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Brand Name
ENCOR NEEDLE GUIDE INSERT
Common Device Name
DISPOSABLE BIOPSY
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
INFUS MEDICAL (THAILAND)
706 moo 4
bangpoo ind estate
samutprakarn province 10280
TH   10280
Manufacturer Contact
brett curtice
800 w. rio salado pkwy
tempe, AZ 85281
4803032689
MDR Report Key17866438
Report Number2020394-2023-00781
Device Sequence Number17630809
Product Code KNW
UDI-Device Identifier00801741086465
UDI-Public(01)00801741086465
Combination Product (Y/N)N
Initial Reporter CountryFI
PMA/510(K) Number
K040842
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Nurse
Type of Report Initial,Followup,Followup
Report Date (Section B) 02/05/2024
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
Operator of Device Health Professional
Device Catalogue NumberENCFINSERT10G
Device Lot NumberVTGR0233
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 09/05/2023
Supplement Date Received by Manufacturer11/28/2023
02/05/2024
Initial Report FDA Received Date10/04/2023
Supplement Report FDA Received Date11/30/2023
02/07/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/06/2022
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
Patient SexFemale
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