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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ARROW INTERNATIONAL LLC ARROW CATH-LAB SHEATH INTRO SET:; CATHETER PERCUTANEOUS

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ARROW INTERNATIONAL LLC ARROW CATH-LAB SHEATH INTRO SET:; CATHETER PERCUTANEOUS Back to Search Results
Catalog Number CL-07865
Medical Device Problem Codes Deformation Due to Compressive Stress (2889); Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/18/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during the procedure, the operating physician had difficulty with advancement of the super arrow flex (saf) sheath and dilator.The physician observed that the tip was dented.There were no reports of patient injury, harm, or adverse health consequences associated with this event.The patient's condition was reported as "fine".No additional medical intervention was reported beyond removal of the affected device, and replacement with another device.
 
Additional Manufacturer Narrative
(b)(4).
 
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Brand Name
ARROW CATH-LAB SHEATH INTRO SET:
Common Device Name
CATHETER PERCUTANEOUS
Manufacturer (Section D)
ARROW INTERNATIONAL LLC
morrisville NC
Manufacturer (Section G)
ARROW INTERNATIONAL DE MEXICO S.A. DE C.V.
ave. washington 3701
colonia panamericana, chihuahua
chihuahua 31200
MX   31200
Manufacturer Contact
katharine tarpley
3015 carrington mill blvd
morrisville, NC 27560
MDR Report Key25435201
Report Number9680794-2026-00432
Device Sequence Number15976441
Product Code DQY
UDI-Device Identifier10801902200850
UDI-Public(01)10801902200850(11)250522(17)300430(10)14F25D0316(21)
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
K862056
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,User Facility,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 05/13/2026
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 NumberCL-07865
Device Lot Number14F25D0316
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/22/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/13/2026
Supplement Date Received by Manufacturer06/10/2026
Initial Report FDA Received Date06/08/2026
Supplement Report FDA Received Date06/18/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/22/2025
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
Concomitant Medical Products
and Therapy/Usage Dates
NOT REPORTED.; NOT REPORTED.
Patient SexUnknown
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