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Visual inspection and functional testing were performed on the returned device.The reported inflation issue was confirmed.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.It was reported that the device was not soaked prior to use.It should be noted that the coronary dilatation catheters (cdc), nc trek neo, instruction for use states: submerge the balloon in sterile heparinized normal saline during balloon preparation, to activate the coating.In this case, it is unknown if the instructions for use (ifu) violation caused or contributed to the reported complaint.Based on the reported information and the observations from the returned analysis, the investigation determined that the reported inflation issue and noted leak appear to be related to operational context.There was no leak or issue noted to the device during preparation, which suggests a product quality issue did not contribute to the reported difficulties.Return device analysis noted a tear located on the outer member on the side of the guidewire exit notch.In this case, it is likely that the device was inadvertently mishandled during preparation and/or during advancement such that the outer member became damaged (tore) and thus resulted in the reported inflation issue and noted leak.There is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.H6 medical device problem code: 2017, failure to follow steps / instructions.
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