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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BARD PERIPHERAL VASCULAR, INC. ULTRAVERSE 035 PTA CATHETER; PTA DILATATION BALLOON CATHETER

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BARD PERIPHERAL VASCULAR, INC. ULTRAVERSE 035 PTA CATHETER; PTA DILATATION BALLOON CATHETER Back to Search Results
Catalog Number U357564
Device Problems Crack (1135); Material Rupture (1546)
Patient Problems No Consequences Or Impact To Patient (2199); No Known Impact Or Consequence To Patient (2692)
Event Date 03/29/2016
Event Type  malfunction  
Manufacturer Narrative
No hospital/medical records or medical images have been made available to the manufacturer.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.The information provided by bard represents all of 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 bard.
 
Event Description
It was reported that during the first inflation in a forearm anastomosis, the pta balloon allegedly ruptured at 3 atm.It was further reported that the device was retracted without incident and another balloon was used to complete the procedure.There was no reported patient injury.
 
Manufacturer Narrative
Manufacturing review: a manufacturing review was conducted and there was nothing found to indicate there was a manufacturing related cause for this event.The lot met all release criteria.Visual/microscopic inspection: the balloon size for this product is printed on the balloon hub of the catheter and identified the returned sample as a 6mm x 40mm balloon.The catheter was kinked 34.6cm and 68.8cm from the distal tip.However after review of the preliminary pictures, the manner in which the device was packaged for return may have contributed to the kinks.No kinks were reported by the user.The balloon appeared to have been previously inflated.No ruptures were noted to the balloon.The inner guidewire lumen was examined underneath the balloon and a crack in the guidewire lumen was noted 5.1cm from the distal tip.The crack was examined under microscopic magnification (10x) and the edges of the crack were jagged and stretched.Functional/performance evaluation: the patency of the guidewire lumen was then tested using an in-house 0.035¿ guidewire and it passed without issue.Upon inflation, water was seen exiting out the distal tip of the balloon.The balloon was unable to be inflated to nominal pressure due to the leak.Medical records review: medical records were not provided; therefore, a review could not be performed.Image/photo review: images/photos were not provided; therefore, a review could not be performed.Conclusion: the device was returned.The investigation is inconclusive for material rupture, as the balloon could not be inflated to rated burst pressure due to a crack in the guidewire lumen that resulted in a leak from the distal tip of the balloon.The root cause for the crack in the guidewire lumen is unknown.It is unknown whether the crack was a result of an incorrectly formed weld bond between the inner shaft and dual lumen during the manufacturing of the device.Operator awareness training was conducted at the manufacturing site as a pro-active measure to draw attention to weld bond quality.Labeling review: the current ultraverse 035 pta catheter instructions for use (ifu) provides general instructions for use of the device, as well as warnings, precautions, and potential complications associated with the device.(b)(4).The information provided by bard represents all of 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 bard.
 
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Brand Name
ULTRAVERSE 035 PTA CATHETER
Type of Device
PTA DILATATION BALLOON CATHETER
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
Manufacturer (Section G)
CLEARSTREAM TECHNOLOGIES LTD.
moyne upper
enniscorthy, co. wexford
EI  
Manufacturer Contact
judith ludwig
1625 w 3rd st.
tempe, AZ 85281
4803032689
MDR Report Key5612057
MDR Text Key44480444
Report Number2020394-2016-00406
Device Sequence Number1
Product Code LIT
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K142261
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,user f
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 03/29/2016
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
Device Operator Health Professional
Device Expiration Date11/30/2018
Device Catalogue NumberU357564
Device Lot Number50132317
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/06/2016
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 04/08/2016
Initial Date FDA Received04/27/2016
Supplement Dates Manufacturer ReceivedNot provided
Supplement Dates FDA Received07/21/2016
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured12/03/2015
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Age50 YR
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