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(b)(4).The customer returned one guidewire within its assembly and an arrow raulerson syringe (ars) for analysis.Signs of use were observed on and within the returned components.Visual inspection of the guidewire revealed three kinks throughout the body.The distal j-bend was also misshapen.Microscopic examination confirmed the damage.Both welds were present and appeared to be full and spherical.The damage to the returned sample matched the customer description of the guidewire becoming kinked and encountering resistance during catheterization.Visual inspection of the ars revealed no obvious defects or anomalies.The kinks on the guidewire measured 350mm, 369mm, and 570mm from the proximal end.The guidewire total length measured 599mm, which is within the specification limits of 596mm - 604mm per the guidewire product drawing.The guidewire outer diameter measured 0.80mm, which is within the specification limits of 0.788mm - 0.826mm per the guidewire product drawing.Functional inspection of the guidewire was performed per the product instructions for use (ifu), which states, "advance guidewire into arrow raulerson syringe approximately 10 cm until it passes through syringe valves or into introducer needle." the guidewire was inserted through the returned ars and lab inventory 18ga introducer needle.It was able to advance with no resistance at the undamaged portion.Major resistance was encountered at the locations of the kinks.A manual tug test confirmed the distal and proximal welds were intact.A device history record review was performed, and no relevant findings were identified.The ifu provided with the kit informs the user, "do not use excessive force when introducing guidewire or tissue dilator as this can lead to vessel perforation, bleeding, or component damage.Do not apply excessive force in placing or removing catheter or guidewire.Excessive force can cause component damage or breakage.If damage is suspected or withdrawal cannot be easily accomplished, radiographic visualization should be obtained and further consultation requested." the report of a kinked guidewire was confirmed through investigation of the returned sample.Visual inspection revealed three kinks throughout the guidewire body.Despite this, the guidewire and ars met all relevant dimensional and functional requirements.A device history record review was performed with no relevant findings.Based on these circumstances, unintentional use error likely caused or contributed to this event.Teleflex will continue to monitor and trend for complaints of this nature.
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