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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. Denali Jugular System; Vena Cava Filter

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BARD PERIPHERAL VASCULAR, INC. Denali Jugular System; Vena Cava Filter Back to Search Results
Catalog Number DL900J
Medical Device Problem Code Detachment of Device or Device Component (2907)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/06/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
H11: as the lot number for the device was provided, a review of the device history records is currently being performed.The device has been returned to the manufacturer for evaluation.The investigation of the reported event is currently underway.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.
 
Event or Problem Description
On (b)(6), 2026, a patient underwent a percutaneous inferior vena cava filter implantation using a denali filter.During the procedure, the sidearms on the sheath detached.The procedure was completed using the same defective sheath.There was no reported patient injury.
 
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Brand Name
Denali Jugular System
Common Device Name
Vena Cava Filter
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
C.R. Bard, Inc. (GFO)
289 bay road
queensbury 12804
Manufacturer Contact
michael gaffney
800 w. rio salado pkwy
tempe, AZ 85281
+1(480)303-2689
MDR Report Key24567029
Report Number2020394-2026-00634
Device Sequence Number8366677
Product Code DTK
UDI-Device Identifier00801741040795
UDI-Public(01)00801741040795(11)251031(17)280928(10)GFKW0823
Combination Product (Y/N)N
Initial Reporter StateMO
Initial Reporter CountryUS
PMA/510(K) Number
K130366
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,User Facility
Initial Reporter Occupation Risk Manager
Type of Report Initial,Followup
Report Date (Section B) 08/05/2026
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
Operator of Device Health Professional
Device Catalogue NumberDL900J
Device Lot NumberGFKW0823
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer03/10/2026
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/18/2026
Supplement Date Received by Manufacturer08/05/2026
Initial Report FDA Received Date03/11/2026
Supplement Report FDA Received Date08/07/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/31/2025
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
Patient SexUnknown
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