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Visual inspection was performed on the returned device.The reported balloon rupture and separation were confirmed.The reported difficulty removing the device could not be replicated in a testing environment as it was based on operational circumstances.Production record and corrective and preventative actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a review of the complaint history identified no other similar complaints from this lot.Based on the reported information and the observations from the returned analysis, the investigation determined that the reported balloon rupture, separation, difficulty removing the device and surgical intervention appear to be related to operational context.There was no leak noted during preparation or during the first two inflations, 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 ruptured.In addition, the ruptured balloon material likely got caught at the previously implanted stent resulting in the reported difficulty removing the device and upon further manipulation, the device ultimately separated.Surgical intervention was performed to remove the device from the patient anatomy.There is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
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