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U.S. Department of Health and Human Services

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

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BOSTON SCIENTIFIC CORPORATION GLADIATOR ELITE; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL Back to Search Results
Model Number H74939207100470
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/28/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that balloon rupture occurred.A 10.0 x40, 75cm gladiator elite balloon catheter was advanced for dilatation.However, during the second inflation at 8 atmospheres for less than 20 seconds, the balloon ruptured.The device was completely removed, and the procedure was completed with a different balloon.No patient complications were reported.
 
Event or Problem Description
It was reported that balloon rupture occurred.A 10.0 x40, 75cm gladiator elite balloon catheter was advanced for dilatation.However, during the second inflation at 8 atmospheres for less than 20 seconds, the balloon ruptured.The device was completely removed, and the procedure was completed with a different balloon.No patient complications were reported.
 
Additional Manufacturer Narrative
Device evaluated by mfr: the device was returned for analysis.A visual examination identified that the balloon was not folded which indicates that the balloon was subjected to positive pressure.A longitudinal tear was identified in the balloon material.The tear measured 57 mm in length and extended from a position 11 mm proximal of the proximal markerband to 8 mm distal of the distal markerband.A partial circumferential tear was noted 9mm proximal from the proximal markerband.A visual examination observed no damage to the 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.
 
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Brand Name
GLADIATOR ELITE
Common Device Name
CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
BOSTON SCIENTIFIC CORPORATION
pmt 741 persiaran cassia selat
bandarcassia, pulau pinan 14110
MY   14110
Manufacturer Contact
rachel shields
4100 hamline ave n
arden hills, MN 55112
6512422111
MDR Report Key20729028
Report Number2124215-2024-72896
Device Sequence Number12886681
Product Code LIT
UDI-Device Identifier08714729809517
UDI-Public08714729809517
Combination Product (Y/N)N
Initial Reporter StateAZ
Initial Reporter CountryUS
PMA/510(K) Number
K132810
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 12/27/2024
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 Model NumberH74939207100470
Device Catalogue NumberH74939207100470
Device Lot Number0034439748
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 10/29/2024
Supplement Date Received by Manufacturer12/12/2024
Initial Report FDA Received Date11/19/2024
Supplement Report FDA Received Date12/27/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/16/2024
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 SexUnknown
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