MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC HEMODIALYSIS KIT 2L: 12 FR X 16CM AGB; CATHETER HEMODIALYSIS IMPLANTE

Catalog Number	AK-22122-CDC
Medical Device Problem Code	Unraveled Material (1664)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/25/2025
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
(b)(4).The report that the guide wire unravelled was confirmed through examination of the returned sample.The customer provided one photo and returned a guidewire partially advanced within a 2-lumen catheter for evaluation.The core wire was broken distal to the proximal weld.The guide wire and catheter did not meet all functional and dimensional requirements during investigation testing.The dimensional analysis confirmed the returned sample did not match the customer reported finished good.The discrepancies with the catheter body length and guide wire length measuring out of specification indicates that the customer either reported the incorrect material number or returned the incorrect product.No manufacturing defects were found during this investigation.A device history record review was performed, and no relevant findings were identified.Arrow guide wires of this size provided within the reported finished good are designed and manufactured to withstand a tensile force of 2.75 pounds force.This internal specification is higher than the required standard of 2.2 pounds force for this size wire.The selected insertion site and patient anatomy may present a tortuous path that could contribute to the possibility of guide wire kinking.Guide wire breakage may occur if a force greater than the design specification is applied during removal.However, based on the discrepancy between the reported finished good and the returned devices, the root cause cannot be determined.Teleflex will continue to monitor and trend for reports of this nature.
Event or Problem Description
It was reported that: "the physician stated that as they were ready to advance the catheter in and pull the guide wire out, he felt like something was wrong and noticed that the guide wire had "unraveled".He pulled out the guide wire with the catheter.There was no patient harm, and the guide wire came out fully intact".

• Brand Name: HEMODIALYSIS KIT 2L: 12 FR X 16CM AGB
• Common Device Name: CATHETER HEMODIALYSIS IMPLANTE
• Manufacturer (Section D): ARROW INTERNATIONAL LLC; morrisville NC
• Manufacturer (Section G): ARROW INTERNATIONAL DE MEXICO S.A. DE C.V.; ave. washington 3701; colonia panamericana, chihuahua; chihuahua 31200 ; MX 31200
• Manufacturer Contact: elaine cully ; 3015 carrington mill blvd; morrisville, NC 27560
• MDR Report Key: 23861950
• Report Number: 9680794-2025-01049
• Device Sequence Number: 15790251
• Product Code: MPB
• UDI-Device Identifier: 50801902123133
• UDI-Public: (01)50801902123133(11)250702(17)270210(10)33F25E0936(21)
• Combination Product (Y/N): N
• Initial Reporter State: NY
• Initial Reporter Country: US
• PMA/510(K) Number: K993933
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: User Facility,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 11/25/2025

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 Catalogue Number: AK-22122-CDC
• Device Lot Number: 33F25E0936
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 12/01/2025
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 11/25/2025
• Initial Report FDA Received Date: 12/22/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 07/02/2025
• 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 Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: NOT REPORTED.
• Patient Sex: Unknown