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A visual and dimensional inspection was performed on the returned device.The reported material deformation was confirmed.The reported difficult to advance and difficult to remove could not be tested due to the condition of the returned device.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.A conclusive cause for the reported difficulties could not be determined; however, factors that could contribute to difficult to advance include, but are not limited to, patient anatomical morphology, patient disease state, guiding catheter support or damage to the guide catheter, anatomical conditions, inner diameter of guide wire lumen, outer diameter of the guide wire, interaction with previously placed stents or accessory devices.Factors that can contribute to difficult to remove include, but are not limited to, anatomical conditions, guiding catheter lumen obstructions, kinks, bends, procedural technique, insufficient support, or interactions with other devices.Factors that could contribute to material deformation include, but are not limited to, inadvertent mishandling during sheath/stylet removal, preparation, during use of the device, or interaction with accessory devices.In this case, it is possible that the distal end of the stent may have become damaged during insertion into the guide catheter, causing the reported material deformation (bent and stretched struts), ultimately contributing to the reported difficult to advance (guide catheter) and difficult to remove (guide catheter), as resistance was noted during advancement and retraction, however, this cannot be confirmed.Based on the 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.
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