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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT VASCULAR INC. SUPERA; STENT, SUPERFICIAL FEMORAL ARTERY

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ABBOTT VASCULAR INC. SUPERA; STENT, SUPERFICIAL FEMORAL ARTERY Back to Search Results
Model Number S-45-120-120-P6
Medical Device Problem Codes Mechanical Jam (2983); Activation Failure (3270)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/26/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was not returned for analysis.Production record and corrective and preventive actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a review of the complaint handling database identified no other incidents.As there was no damage noted to the device during the inspection prior to use, the investigation determined the reported difficulties appear to be related to circumstances of the procedure as it is likely that the distal sheath of the delivery system was entrapped or bent in the heavily calcified and 90% stenosed anatomy such that the ratchet was unable to properly/fully engage the stent resulting in the resistance felt in the thumbslide, resulting in the reported activation/deployment failure.Based on the reported information and results of the complaint investigation there is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
 
Event or Problem Description
It was reported that the procedure performed was to treat a heavily calcified, superficial femoral artery that is 90% stenosed.The vessel was prepped with an unspecified balloon.The 4.5x120mm supera self-expanding stent was attempted to be deployed, could not be pushed out of the delivery sheath, and only partially deployed as there was resistance with the thumbslide.The supera was removed under fluoroscopy.An unspecified stent was used to complete the procedure.There were no adverse patient effects and no clinically significant delay in the procedure.No additional information was provided.
 
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Brand Name
SUPERA
Common Device Name
STENT, SUPERFICIAL FEMORAL ARTERY
Manufacturer (Section D)
ABBOTT VASCULAR INC.
3200 lakeside drive
santa clara CA 95054 2807
Manufacturer (Section G)
ABBOTT VASCULAR, REG # 2024168
26531 ynez road
temecula CA 92591 4628
Manufacturer Contact
lindsey bell
26531 ynez rd.
temecula, CA 92591-4628
9519143996
MDR Report Key22197047
Report Number2024168-2025-06089
Device Sequence Number8837640
Product Code NIP
UDI-Device Identifier08717648226007
UDI-Public(01)08717648226007(17)260131(10)4022761
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
P120020
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) 06/12/2025
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 Date01/31/2026
Device Model NumberS-45-120-120-P6
Device Catalogue NumberS-45-120-120-P6
Device Lot Number4022761
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/27/2025
Initial Report FDA Received Date06/12/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/27/2024
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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