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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW ULTRAFLEX IAB: 7.5FR 40CC; SYSTEM, BALLOON, INTRA-AORTIC

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ARROW INTERNATIONAL LLC ARROW ULTRAFLEX IAB: 7.5FR 40CC; SYSTEM, BALLOON, INTRA-AORTIC Back to Search Results
Catalog Number IAB-06840-U
Medical Device Problem Code Device Alarm System (1012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/21/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).
 
Event or Problem Description
It was reported "after the surgery is completed, the pump reported the helium loss alarm.Remove the catheter".Additional info states that the iab catheter was not replaced.No patient injury or consequence reported.The patient's current condition is reported as "fine".
 
Event or Problem Description
It was reported "after the surgery is completed, the pump reported the helium loss alarm.Remove the catheter".Additional info states that the iab catheter was not replaced.No patient injury or consequence reported.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 bio-hazard bag.Upon return, the supplied teflon sheath was noted on the iabc outer lumen.The one-way valve was noted disconnected from the short driveline tubing and was returned with the sample; no visual damage or abnormal-ities were noted to the one-way valve.The supplied 40cc inflation driveline tubing was noted con-nected to the short driveline tubing.A clear plastic tape was noted wrapped around the bifurcate and the short driveline tubing and inflation driveline tubing connection.The iabc bladder was fully unwrapped.Spots of dried blood were noted on the exterior surfaces of the returned sample.No obvious blood was noted within the helium pathway.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 according to quality system document.The iabc central lumen was aspirated and flushed using a 60cc lab-inventory syringe.No abnormalities or debris were noted.The iabc was leak tested in accord-ance with testing methods from manufacturing procedure.An external leak was immediately de-tected from the distal end of the bifurcate bushing.Under microscopic inspection, the leak from the bifurcate bushing occurred from the adhesive bond.No other leaks were detected.A lab in-ventory 0.025in guidewire was back loaded through the iabc distal tip.No resistance was noted; the guidewire was able to advance through the central lumen.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 "pump reported the helium loss alarm" is confirmed.During the complaint investigation, an external helium leak was confirmed from the intra-aortic balloon catheter (iabc) bifurcate bushing adhesive, which resulted in a helium loss alarm.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 external leak from the iabc bifurcate bushing adhesive.The probable root cause is manufacturing related.A corrective and preventive action (capa) has been initiated to address the issue.
 
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Brand Name
ARROW ULTRAFLEX IAB: 7.5FR 40CC
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 Key24365321
Report Number3010532612-2026-00138
Device Sequence Number5381181
Product Code DSP
UDI-Device Identifier10801902145748
UDI-Public(01)10801902145748(11)241217(17)261130(10)18F24M0100(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) 01/23/2026
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-06840-U
Device Lot Number18F24M0100
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/03/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/23/2026
Supplement Date Received by Manufacturer02/17/2026
Initial Report FDA Received Date02/17/2026
Supplement Report FDA Received Date03/03/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/17/2024
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
Patient SexUnknown
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