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H10: as the lot number for the device was provided, a review of the device history records is currently being performed.The return of the sample is pending.The investigation of the reported event is currently underway.H11: section a through f: the information provide by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
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H10: manufacturing review: a complaint history review was performed.This is the first complaint reported for this product/lot number combination.However, the device history records were reviewed and there was nothing found to indicate there was a manufacturing related cause for this event.Investigation summary: the lifestream device was returned for evaluation.The lifestream shaft was kinked at the location 180mm from the strain relief.The stent was returned on the balloon positioned correctly and secure between the marker bands.There was no evidence of stent expansion.No damage was noted.The lifestream was also tested for sheath compatibility.An in house terumo 6fr 10cm sheath was obtained and the lifestream device was inserted through the sheath without difficulty.There was no movement of the stent observed during insertion into the sheath.The stent was secure and remained in position between the marker bands having been passed through the sheath.Therefore, the result of the investigation is confirmed for the reported catheter kink issue and unconfirmed for the stent dislodgement issue.The root cause for the reported stent dislodgement and catheter kink issues could not be determined based upon the available information received from the field communication and device evaluation.Labeling review: the instructions for use for this lifestream device was reviewed and the following sections are applicable.B indication for use: the lifestream balloon expandable vascular covered stent is indicated for the treatment of atherosclerotic lesions in common and external iliac arteries with reference vessel diameters between 4.5 mm and 12.0 mm, and lesion lengths up to 100 mm.C contraindications: the lifestream balloon expandable vascular covered stent is contraindicated for use in: patients with uncorrected bleeding disorders.Patients who cannot receive recommended antiplatelet and/or anticoagulation therapy patients who are judged to have a lesion that prevents full expansion of the implant.Lesions in which the lumen diameter post balloon angioplasty is insufficient for the passage of the endovascular system.Lesion locations subject to external compression d warnings: the lifestream balloon expandable vascular covered stent is supplied sterile and is intended for single use only.Do not resterilize and/or reuse the device.Reuse, resterilization, reprocessing and/or repackaging may create a risk of patient or user infection, compromise the structural integrity and/or essential material and design characteristics of the device, which may lead to device failure, and/or injury, illness or death of the patient.Do not use if packaging/pouch is damaged.Use the device prior to the use by date specified on the package.The covered stent cannot be repositioned after it is deployed.Do not expose the covered stent to temperatures higher than 500 °f (260 °c).Eptfe decomposes at elevated temperatures, producing highly toxic decomposition products.Use of a laser on or around the surface of the covered stent may result in damage to the covered stent and could create toxic fumes, which may harm the patient or operator.E precautions: the device should only be used by physicians who are trained in endovascular procedures and are familiar with the complications, side effects and hazards of peripheral vascular interventions.Prior to device use, refer to the covered stent sizing table on the label and read the instructions for use.Do not use if the delivery system cannot be properly flushed.Crossing the implant with catheters or other adjunct devices can result in covered stent dislodgement or damage.Store in a cool and dry place.Keep away from sunlight.J storage store in a cool, dry place.Keep away from sunlight.Use the device prior to the use by date specified on the package.M directions for use covered stent size selection 3.Select a covered stent diameter that is approximately 5% - 20% larger than the largest reference vessel diameter at the proximal or distal target site.Refer to the sizing table on the packaging label for appropriate selection of the covered stent diameter and length.Endovascular system preparation: 4.Carefully remove the selected device from the package.Remove the covered stent guard, being cautious not to grasp the covered stent with the guard.5.Inspect the covered stent for adherence to the balloon and centered placement in relation to the balloon marker bands.If the covered stent is not centered and/ or does not firmly adhere to the balloon, do not use.6.Flush the delivery system guidewire lumen with sterile saline mixture until saline drops from the distal end of the endovascular system.Air evacuation: 7.A 20 cc or smaller luer lock syringe with a minimum of 5 cc's sterile saline mixture is recommended for use for aspirating this device.8.With the distal balloon tip pointing down and positioned below the level of the syringe, pull negative pressure until all air is expelled.9.Induce a negative pressure to remove any air from the balloon and inflation lumen.Repeat until all air is expelled.10.Carefully release to neutral.Allow the inflation lumen to fill with the diluted contrast medium and maintain a neutral pressure.Important: do not apply positive pressure to the balloon.11.Attach the prefilled inflation device to the inflation lumen of the catheter hub, ensuring no air bubbles remain at the catheter connection.12.Verify that the covered stent is still centered between the two radiopaque markers on the balloon catheter.Introduction of the endovascular system and placement of the covered stent 13.Advance the endovascular system over the guidewire into the introducer sheath.14.Further advance the endovascular system to the target treatment site within the introducer sheath and position the covered stent across the lesion.Verify that the covered stent is still centered within the balloon marker bands.Slowly retract the introducer sheath / guiding catheter while maintaining the position of the covered stent.Ensure the introducer sheath is retracted far enough to not compromise the balloon expansion and covered stent release.H10: g3, h6 (component) h11: b5, d4 (unique identifier (udi) #), h6 (device, method, result, conclusion) h11: section a through f ¿ the information provide by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
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