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Qn# (b)(4).The customer returned a 1-lumen picc catheter for analysis.Signs of use were observed on the catheter body.Visual analysis revealed one distinct kink towards the distal end of the catheter body.Continuous bends were also observed across the catheter body.Microscopic examination confirmed the damage.No other defects or anomalies were observed.The kinks measured 58mm and 72mm from the juncture hub.The catheter body length measured 18.94" , which is not within the specification limits of 21.99"-22.49" per catheter product drawing.It can be assumed between 3.05"-3.55" of the distal end of the catheter was trimmed.The catheter body outer diameter measured 0.056", which is within the specification limits of 0.054"-0.057" per the catheter body extrusion product drawing.A lab inventory syringe filled with water was attached to the extension line and flushed.There was a significant blockage of biomaterial within the catheter body.The blockage was removed and the catheter flushed as normal.Performed per ifu statement, "flush each lumen with sterile normal saline for injection to establish patency and prime lumen(s)." a lab inventory guide wire (outer diameter measured 0.018") was inserted through the distal lumen.Minor resistance was encountered at the location of the kinking.Performed per ifu statement, "if 130 cm guidewire is used, insert soft tip of the guidewire through peel-away sheath to desired depth.Thread catheter over guidewire and advance catheter over guidewire to final indwelling position using image guidance or fluoroscopy." a device history record review was performed, and no relevant findings were identified.The ifu provided with the kit informs the user, "ensure catheter patency prior to use, including prior to pressure injection.Do not use syringes smaller than 10 ml to reduce risk of intraluminal leakage or catheter rupture.Power injector equipment may not prevent over pressurizing an occluded or partially occluded catheter." the ifu also states, "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 catheter was confirmed through investigation of the returned sample.Visual analysis revealed two kinks along the catheter body.Resistance was noted at the kinking when passing a lab inventory guidewire through the catheter.Despite the damage, the catheter met all relevant dimensional requirements, and a device history record review did not reveal any relevant findings.Based on the customer report that the damage was observed during use and evaluation of the sample received, unintentional use error likely caused or contributed to this event.Teleflex will continue to monitor and trend for reports of this nature.
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