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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOTRONIK AG, BUELACH, SWITZERLAND PASSEO-18 2/200/150; PERIPHERAL DILATATION CATHETER

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BIOTRONIK AG, BUELACH, SWITZERLAND PASSEO-18 2/200/150; PERIPHERAL DILATATION CATHETER Back to Search Results
Model Number 376296
Medical Device Problem Codes Fluid/Blood Leak (1250); Inflation Problem (1310); Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/09/2024
Type of Reportable Event Malfunction
Event or Problem Description
The passeo-18 peripheral balloon catheter was selected for treatment of the moderate calcified lesion (70 percent stenosis degree) in a moderately tortuous part of the mid infrapopliteal artery.The balloon could not be inflated.A balloon leakage was found outside of body.
 
Additional Manufacturer Narrative
The returned product was subjected to a detailed technical analysis and the corresponding production documentation was reviewed to establish whether a deviation from the manufacturing process could be the cause for the reported event.The technical investigation revealed that the balloon has burst longitudinally over a length of about 13 mm, beginning 68 mm distal to the proximal x-ray marker.Microscopic inspection of the balloon surface revealed scratches in close vicinity of the tear which have likely been caused by a hard, sharp-edged object such as e.G., anatomical structure.Review of the production documentation confirmed that the device was manufactured according to specifications and passed all in-process and final inspections.In addition to visual inspections each device is tested for air tightness by means of a pressure test and a helium leak test.Based on the conducted investigations of the device being subject to this complaint, no material or manufacturing related root cause could be determined.The root cause for the reported event is most likely related to the patients anatomy.
 
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Brand Name
PASSEO-18 2/200/150
Common Device Name
PERIPHERAL DILATATION CATHETER
Manufacturer (Section D)
BIOTRONIK AG, BUELACH, SWITZERLAND
ackerstrasse 6
buelach CH-81 80
CH  CH-8180
Manufacturer Contact
6024 jean road
lake oswego, OR 97035
8772459800
MDR Report Key21093386
Report Number1028232-2025-00054
Device Sequence Number8664888
Product Code LIT
UDI-Device Identifier07640130430037
UDI-Public(01)07640130430037(17)2704
Combination Product (Y/N)N
Initial Reporter CountryCN
PMA/510(K) Number
K072765
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,User Facility,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/06/2025
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 Number376296
Device Catalogue Number376296
Device Lot Number03243438
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 01/06/2025
Supplement Date Received by Manufacturer02/06/2025
Initial Report FDA Received Date01/07/2025
Supplement Report FDA Received Date02/06/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/09/2024
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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