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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Venclose, Inc. Venclose EVSRF Catheter; Venous Catheter

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Venclose, Inc. Venclose EVSRF Catheter; Venous Catheter Back to Search Results
Catalog Number VC-10A25-6F-100
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code Burn(s) (1757)
Date of Event 02/26/2020
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
H11: manufacturing review: a manufacturing review was not requested as the lot number reported is unknown.Investigation summary: the physical device was not returned for evaluation.No photos were provided for review.Therefore, the investigation is inconclusive for the reported failure as no objective evidence was provided for review.A definitive root cause for the reported skin burn could not be determined based upon the provided information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required 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 radiofrequency ablation procedure using the venclose catheter.Following the procedure, the patient experienced second degree burns and presented to a general practitioner the following day.The patient status is unknown.
 
Event or Problem Description
On (b)(6)2026, a patient underwent a radiofrequency ablation procedure using the venclose catheter.Following the procedure, the patient experienced second degree burns and presented to a general practitioner the following day.The patient status is unknown.
 
Additional Manufacturer Narrative
H11: this supplemental report is submitted to correct an error in the previously submitted reports.The initial mdr captured an incorrect manufacturing location (g1).The correct manufacturing location for this device is viant costa rica, s.A.No new event information is being reported in this supplement.Manufacturing review: a manufacturing review was not requested as the lot number reported is unknown.Investigation summary: the physical device was not returned for evaluation.No photos were provided for review.Therefore, the investigation is inconclusive for the reported failure as no objective evidence was provided for review.A definitive root cause for the reported skin burn could not be determined based upon the provided information.Labeling review: as the reported event did not allege a labeling or use related issue, a labeling review is not required.G1, g3.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.
 
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Brand Name
Venclose EVSRF Catheter
Common Device Name
Venous Catheter
Manufacturer (Section D)
Venclose, Inc.
2750 n. first street
2nd floor, #221
san jose CA 95131
Manufacturer (Section G)
Viant Costa Rica, S.A.
pq zona franca metropolitana
edificio 2c
barreal de heredia CA 40104
CS   40104
Manufacturer Contact
michael gaffney
800 w. rio salado pkwy
tempe, AZ 85281
+1(480)303-2689
MDR Report Key25794280
Report Number3011879048-2026-00057
Device Sequence Number21079349
Product Code GEI
UDI-Device Identifier00858254006015
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
K160754
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Foreign,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 09/22/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Health Professional
Device Catalogue NumberVC-10A25-6F-100
Device Lot NumberUnknown
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/25/2026
Supplement Date Received by Manufacturer09/21/2026
Initial Report FDA Received Date07/13/2026
Supplement Report FDA Received Date09/22/2026
Was Device Evaluated by Manufacturer? (Y/N) No
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
Outcome Attributed to Adverse Event Required Intervention;
Patient SexUnknown
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