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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT VASCULAR INC. NC TREK NEO¿; CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS

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ABBOTT VASCULAR INC. NC TREK NEO¿; CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS Back to Search Results
Model Number 1400450-08
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/13/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the procedure was to treat a 90% stenosed de novo lesion in the proximal right coronary artery (prca) with heavy calcification and moderate tortuosity.The 4.5x8mm trek balloon dilatation catheter (bdc) was advanced to the target lesion to post dilate the proximal end of the xience skypoint stent; however, the balloon ruptured during the first inflation at 6 atmospheres (atm).Therefore, the bdc was removed from the patient.There was no adverse patient effect and no clinically significant delay reported in the procedure.A non-abbott balloon was used to complete the procedure.No additional information was provided.
 
Additional Manufacturer Narrative
The device was not returned for analysis.Production record and corrective and preventative actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a query of the complaint handling database for the reported lot revealed there is no indication of a lot specific issue.Based on the information received, the investigation determined that the reported balloon rupture appears to be related to operational context.There was no leak noted during preparation, which suggests a product quality issue did not contribute to the reported difficulties.In this case, it is likely that the balloon interacted with the heavily calcified anatomy such that the balloon became damaged and subsequently ruptured during inflation.There is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
 
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Brand Name
NC TREK NEO¿
Common Device Name
CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS
Manufacturer (Section D)
ABBOTT VASCULAR INC.
3200 lakeside drive
santa clara CA 95054 2807
Manufacturer (Section G)
ABBOTT VASCULAR COSTA RICA, REG # 3009564766
52 calle 3 b31 coyol free zone
el coyol alajuela
CS  
Manufacturer Contact
lindsey bell
26531 ynez rd.
temecula, CA 92591-4628
9519143996
MDR Report Key20800704
Report Number2024168-2024-14043
Device Sequence Number7809810
Product Code LOX
UDI-Device Identifier08717648232749
UDI-Public(01)08717648232749(17)251031(10)21123G1
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K220634
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative,Distributor
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 11/27/2024
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 Expiration Date10/31/2025
Device Model Number1400450-08
Device Catalogue Number1400450-08
Device Lot Number21123G1
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/14/2024
Initial Report FDA Received Date11/27/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/23/2022
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
4X12MM XIENCE SKYPOINT STENT
Patient SexUnknown
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