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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT VASCULAR INC. SUPERA; STENT, SUPERFICIAL FEMORAL ARTERY

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ABBOTT VASCULAR INC. SUPERA; STENT, SUPERFICIAL FEMORAL ARTERY Back to Search Results
Model Number S-55-120-120-P6
Medical Device Problem Code Activation Failure (3270)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/03/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Manufacturer's investigation is still pending at this time.Results and conclusions will be provided in the final report.
 
Event or Problem Description
It was reported that the procedure was to treat a mildly calcified popliteal artery lesion.A 5.5 x 120 mm supera self expanding stent system (ses) was advanced to the target lesion without issue.However, the stent came out of the patient anatomy with the delivery system during removal.An additional supera ses was used to complete the procedure.There were no adverse patient sequela and there was no clinically significant delay in the procedure.No additional information was provided.
 
Additional Manufacturer Narrative
The device was returned for analysis.The reported activation failure was unable to be confirmed as the stent was deployed and not returned.Production record and corrective and preventative actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a review of the complaint handling database identified no other incidents from this lot.As there was no damage noted to the device during the inspection prior to use, the investigation determined the reported difficulties appear to be related to circumstances of the procedure as it is likely that the distal sheath of the delivery system was entrapped or bent in the mildly calcified anatomy such that the ratchet was unable to properly/fully engage the stent resulting in the stent coming out of the patient anatomy with the delivery system during removal; thus resulting in the reported activation failure.Based on the reported information and results of the complaint investigation there is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
 
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Brand Name
SUPERA
Common Device Name
STENT, SUPERFICIAL FEMORAL ARTERY
Manufacturer (Section D)
ABBOTT VASCULAR INC.
3200 lakeside drive
santa clara CA 95054 2807
Manufacturer (Section G)
ABBOTT VASCULAR, REG # 2024168
26531 ynez road
temecula CA 92591 4628
Manufacturer Contact
lindsey bell
26531 ynez rd.
temecula, CA 92591-4628
9519143996
MDR Report Key24681315
Report Number2024168-2026-01196
Device Sequence Number18573596
Product Code NIP
UDI-Device Identifier08717648226144
UDI-Public(01)08717648226144(17)260930(10)4102361
Combination Product (Y/N)N
Initial Reporter StatePR
Initial Reporter CountryUS
PMA/510(K) Number
P120020
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 04/29/2026
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 Expiration Date09/30/2026
Device Model NumberS-55-120-120-P6
Device Catalogue NumberS-55-120-120-P6
Device Lot Number4102361
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/06/2026
Supplement Date Received by Manufacturer04/06/2026
Initial Report FDA Received Date03/24/2026
Supplement Report FDA Received Date04/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/23/2024
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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