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U.S. Department of Health and Human Services

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

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ABBOTT VASCULAR INC. TREK; CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS Back to Search Results
Model Number 1012272-08
Medical Device Problem Code Material Rupture (1546)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/28/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the procedure was to treat the proximal left anterior descending (plad) artery with heavy calcification.The 2.5x8mm trek rx balloon dilatation catheter (bdc) was advanced to the target lesion and the balloon was inflated; however, during the first inflation at 2 atmospheres (atm) the balloon ruptured.The procedure was continued with a 2.5x12mm trek rx bdc.There were no adverse patient effects and no clinically significant delay in 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 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
TREK
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 Key21656413
Report Number2024168-2025-02921
Device Sequence Number21140987
Product Code LOX
UDI-Device Identifier08717648138270
UDI-Public(01)08717648138270(17)251231(10)30114G2
Combination Product (Y/N)N
Initial Reporter StateCA
Initial Reporter CountryUS
PMA/510(K) Number
K103110
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 03/20/2025
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 Expiration Date12/31/2025
Device Model Number1012272-08
Device Catalogue Number1012272-08
Device Lot Number30114G2
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/28/2025
Initial Report FDA Received Date03/20/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/14/2023
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 Age52 YR
Patient SexFemale
Patient Weight73 KG
Patient EthnicityHispanic
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