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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT VASCULAR INC. TREK¿; CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS

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ABBOTT VASCULAR INC. TREK¿; CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS Back to Search Results
Model Number 1012272-12
Medical Device Problem Codes Material Separation (1562); Deformation Due to Compressive Stress (2889)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/22/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was not returned for analysis.Production record and corrective and preventative actions (capa) reviews were performed and revealed no indication of a product quality issue.Additionally, a query of the complaint handling database for the reported lot revealed there is no indication of a lot specific issue.Based on the information received, the investigation determined that the reported complaints appear to be related to operational context.In this case, it is likely that the balloon dilatation catheter (bdc) was inadvertently mishandled during removal from the packaging such that the shaft became kinked and upon further manipulation during preparation the device ultimately separated.There is no indication of a product quality issue with respect to the design, manufacture, or labeling of the device.
 
Event or Problem Description
It was reported that prior to use the proximal shaft of the 2.5x12mm trek balloon dilatation catheter (bdc) was noted to be kinked and the hub separated from the bdc during preparation.The bdc was not used in the procedure.There was no patient involvement and no clinically significant delay reported in the procedure.No additional information was provided.
 
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Brand Name
TREK¿
Common Device Name
CATHETERS, TRANSLUMINAL CORONARY ANGIOPLASTY, PERCUTANEOUS
Manufacturer (Section D)
ABBOTT VASCULAR INC.
3200 lakeside drive
santa clara CA 95054 2807
Manufacturer (Section G)
ABBOTT VASCULAR COSTA RICA, REG # 3009564766
52 calle 3 b31 coyol free zone
el coyol alajuela UNK
CS   UNK
Manufacturer Contact
lindsey bell
26531 ynez rd.
temecula, CA 92591-4628
9519143996
MDR Report Key25156849
Report Number2024168-2026-01946
Device Sequence Number13106087
Product Code LOX
UDI-Device Identifier08717648138287
UDI-Public(01)08717648138287(17)280831(10)50929G1
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
K180040
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 05/12/2026
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 Model Number1012272-12
Device Catalogue Number1012272-12
Device Lot Number50929G1
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/22/2026
Initial Report FDA Received Date05/12/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/29/2025
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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