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H11: manufacturing review: based on the information available it is not reasonably suggested that a manufacturing process may have caused or contributed to the reported issue.However, the lot history records of this lot were reviewed with special attention to the manufacturing and inspection of this product, and the product was found to have met the specification prior to shipment.Investigation summary: the stent delivery system sample was returned for evaluation, and the stent graft was still loaded in the delivery system, and the outer sheath was fracture which leads to confirmed results for positioning failure and sheath fracture.In this case, it was reported that a 10f introducer was used for access, the tracking vessel was curved but not calcified, the lesion was pre-dilated and the device was properly flushed before use.Based on the information available, a root cause could not be determined.Based on the provided information and the evaluation of the returned sample, the investigation is closed with confirmed results for positioning failure and sheath fracture.A definite root cause for the reported event could not be determined.Labeling review: in reviewing the relevant labeling, it was found that the instructions for use (ifu) sufficiently address the potential risks.The ifu state: if unusual resistance or high deployment force is encountered during stent graft deployment, abort the procedure, remove the delivery system and use an alternative device.Regarding preparation of the device the ifu state that prior to loading the vascular system over a guide wire, both ports must be flushed with sterile saline.Flushing these lumens will also facilitate stent graft deployment.Regarding the anatomy of the placement site the ifu states: prior to stent graft deployment, ensure that the proximal stent graft end is positioned in a straight section of the lumen to reduce the risk of increased deployment forces and possible failure to deploy.Regarding accessories the ifu states: prepare a stiff 0.035 guidewire per its instructions for use and advance the guidewire under fluoroscopy to the target location.The use of an appropriately sized introducer sheath is recommended.The packaging pictograms indicate an introducer size of 9f and a 0.035 guidewire.Section a through f: the information provide by bd represents all the known information at this time.Despite good faith efforts to obtain additional information, the complainant/reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
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