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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW ULTRAFLEX IAB: 7.5FR 30CC; SYSTEM, BALLOON, INTRA-AORTIC

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ARROW INTERNATIONAL LLC ARROW ULTRAFLEX IAB: 7.5FR 30CC; SYSTEM, BALLOON, INTRA-AORTIC Back to Search Results
Catalog Number IAB-06830-U
Medical Device Problem Code Material Deformation (2976)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/13/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).
 
Event or Problem Description
It was reported "after the catheter inserted into the patient, the balloon failed to inflate.After remove the catheter, central lumen was found rupture.The new catheter".The patient's current condition is reported as "fine".
 
Event or Problem Description
It was reported "after the catheter inserted into the patient, the balloon failed to inflate.After remove the catheter, central lumen was found rupture.The new catheter".The patient's current condition is reported as "fine".
 
Additional Manufacturer Narrative
(b)(4).The serial number on the returned sample is (b)(6).Returned for investigation was a 40cc 7.5fr ultraflex intra-aortic balloon catheter (iabc) without the original packaging.The sample was returned in a cardboard box and was in a sealed ziploc bag.Upon return, the peel away sheath was noted on the iabc outer lumen.The one-way valve was connected and tethered to the short driveline tubing.The bladder was fully unwrapped.The iabc central lumen was noted broken at approximately 1.5cm from the iabc distal tip.Spots of dried blood were noted on the exterior surfaces of the returned sample.No obvious blood was noted within the helium pathway.No other visual damage or abnormalities were noted to the returned sample.The customer sub-mitted photos were reviewed.In the photo, the iabc central lumen was noted broken near the iabc distal tip.The photo shows the teleflex china label with lot number information, which matches with the lot number reported on the complaint report.The one-way valve was tested and passed.A vacuum was pulled on the one-way valve, and it held for at least 1 minute accord-ing to quality system document.An attempt to aspirate and flush the iabc central lumen using a 60cc lab-inventory syringe was unable to be successfully completed.Upon aspiration, water was unable to be consistently pulled into the syringe.The attempt to flush resulted in bladder infla-tion, which is consistent with the previously confirmed broken central lumen.The iabc was leak tested in accordance with testing methods from manufacturing procedure.A leak was immediately detected from the iabc distal tip and iabc luer end.The leak from the iabc distal tip and iabc luer end are consistent with the previously confirmed broken central lumen.The iabc was leak tested again with the iabc distal tip and iabc luer end blocked off; no other leaks were detected.A lab inventory 0.025in guidewire was back loaded through the iabc distal tip.The guidewire exited the central lumen and entered the bladder at the previously noted central lumen break.No blood or debris was noted.The guidewire was front loaded through the iabc luer.The guidewire exited the central lumen and entered the bladder at the previously noted central lumen break.No blood or debris was noted.A device history record (dhr) review was conducted for the lot number with no relevant findings.The device passed all manufacturing specifications prior to release.The reported complaint that the "balloon failed to inflate" is confirmed.During the investigation, the intra aortic balloon catheter (iabc) central lumen was noted broken near the iabc distal tip.A break in the central lumen can result in difficulty inflating the bladder due to the leak.The returned intra-aortic balloon catheter (iabc) bladder membrane was fully intact, with no leaks noted.Based on a review of the device history record (dhr), the product met specification upon release; however, the specifications were not met during the complaint investigation due to the broken central lumen.The root cause of the broken central lumen is undetermined.No further action required at this time.This will be monitored for any developing trends.
 
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Brand Name
ARROW ULTRAFLEX IAB: 7.5FR 30CC
Common Device Name
SYSTEM, BALLOON, INTRA-AORTIC
Manufacturer (Section D)
ARROW INTERNATIONAL LLC
morrisville NC
Manufacturer (Section G)
ARROW INTERNATIONAL INC.
16 elizabeth drive
chelmsford MA 01824
Manufacturer Contact
sachin sony
3015 carrington mill blvd
morrisville, NC 27560
MDR Report Key23956019
Report Number3010532612-2026-00007
Device Sequence Number5610001
Product Code DSP
UDI-Device Identifier10801902145625
UDI-Public(01)10801902145625(11)250405(17)270331(10)18F25C0139(21)
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K000729
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 12/08/2025
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
Device Catalogue NumberIAB-06830-U
Device Lot Number18F25C0139
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/08/2025
Supplement Date Received by Manufacturer01/12/2026
Initial Report FDA Received Date01/05/2026
Supplement Report FDA Received Date01/20/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/05/2025
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
N/A.; N/A.
Patient SexUnknown
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