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Qn#(b)(4).The customer returned two images for analysis.Visual analysis confirmed multiple kinks on the catheter body.Signs of_use in the form of biological material were also observed.The customer returned one, 2-lumen pressure injectable (pi) picc catheter for analysis.Signs of use in the form of biological material were observed inside the luer hubs.It was noted that the catheter body was trimmed at the 42cm marking.The severed portion was not returned.Visual analysis revealed five kinks along the catheter body extrusion.Microscopic examination confirmed the damage.No other defects or anomalies were observed.The kinks measured 10mm, 24mm, 31mm, 45mm, and 69mm from the juncture hub.The catheter body length from the juncture hub to the severed end measured 17.3", which indicates that between 4.69"-5.19" of the catheter body was severed and not returned (per catheter product drawing.The catheter body outer diameter measured 0.068", which is within the specification limits of 0.066"-0.071" per the catheter body extrusion product drawing.A lab inventory syringe filled with water was attached to both extension lines and flushed.No obvious resistance or blockages were observed.Performed per ifu statement, "flush each lumen with sterile normal saline for injection to establish patency and prime lumen(s)".A lab inventory guide wire (outer diameter measured 0.0175") was inserted through the distal lumen.Minor resistance was encountered at the location of the kinking.Performed per ifu statement, "if 130 cm guidewire is used, insert soft tip of the guidewire through peel-away sheath to desired depth.Thread catheter over guidewire and advance catheter over guidewire to final indwelling position using image guidance or fluoroscopy.".A device history record review was performed, and no relevant findings were identified.The ifu provided with the kit informs the user, "ensure catheter patency prior to use, including prior to pressure injection.Do not use syringes smaller than 10 ml to reduce risk of intraluminal leakage or catheter rupture.Power injector equipment may not prevent over pressurizing an occluded or partially occluded catheter".The ifu also states, "do not apply excessive force in placing or removing catheter or guidewire.Excessive force can cause component damage or breakage".The ifu also states, "do not secure, staple and/or suture directly to outside diameter of catheter body or extension lines to reduce risk of cutting or damaging the catheter or impeding catheter flow.Secure only at indicated stabilization locations".The report of a kinked catheter was confirmed through complaint investigation.Visual analysis revealed five kinks along the catheter body.Resistance was noted at the kinking when passing a lab inventory guide wire through the catheter.Despite the damage, the catheter met all relevant dimensional requirements, and a device history record review did not reveal any relevant findings.Based on the customer report that the damage was observed during use and evaluation of the sample received, unintentional use error likely caused or contributed to this event.Teleflex will continue to monitor and trend for reports of this nature.
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