MAUDE Adverse Event Report: CORDIS CORPORATION SABER 4MM4CM 90; CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL

Model Number	48004004S
Medical Device Problem Code	Burst Container or Vessel (1074)
Health Effect - Clinical Code	No Consequences Or Impact To Patient (2199)
Date of Event	05/29/2017
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
It was reported that a saber balloon catheter (bc) ruptured at five atmospheres (5 atm).Therefore it was replaced with a non cordis balloon catheter and the procedure was completed successfully.There was no reported patient injury.The target lesion was the left popliteal artery.The patient¿s vessel level of tortuousness and calcification was unknown.The rate of stenosis was unknown.The device inflated normally.There were no difficulties removing the product from the hoop, the protective balloon cover, the stylet or any of the sterile packaging components.There were no kinks or other damages noted prior to inserting the product the product into the patient.A non-cordis guidewire and a non cordis micro catheter were inserted and an attempt was made to inflate a saber percutaneous transluminal angioplasty balloon catheter.However it ruptured.The product was removed intact (in one piece) from the patient.No other information was provided.The device was not returned for analysis.A device history record (dhr) review of lot 17029240 revealed no anomalies or non-conformances during the manufacturing and inspection processes that can be associated with the reported event.The reported ¿balloon burst - at/below rbp¿ could not be confirmed as the device was not returned for analysis.The exact cause of the burst reported could not be determined.Based on the limited information available for review, vessel characteristics (although unknown) may have contributed to the reported event.According to the instructions for use, which is not intended as a mitigation, ¿the rated burst pressure is based on the results of in vitro testing.At least 99.9% of the balloons (with a 95% confidence) will not burst at or below their rated burst pressure.Use of a pressure monitoring device is recommended to prevent over-pressurization.¿ neither the dhr nor the information available suggests a design or manufacturing related cause for the reported event; therefore, no corrective/preventive action will be taken.
Event or Problem Description
It was reported that a saber balloon catheter ruptured at five atmosphere (5 atm).Therefore it was replaced with a non cordis balloon catheter and the procedure was completed successfully.There was no reported patient injury.A guidewire (chevalier, fmd) and a non cordis micro catheter were inserted and an attempt was made to inflate a saber percutaneous transluminal angioplasty balloon catheter.However it ruptured.The target lesion was the left popliteal artery.The patient¿s vessel level of tortuousness and calcification was unknown.The rate of stenosis was unknown.The device inflated normally.There were no difficulties removing the product from the hoop, the protective balloon cover, the stylet or any of the sterile packaging components.There were no kinks or other damages noted prior to inserting the product the product into the patient.The product was removed intact (in one piece) from the patient.The product was clinically used and will not be returned for analysis.No other information was provided.

• Brand Name: SABER 4MM4CM 90
• Common Device Name: CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL
• Manufacturer (Section D): CORDIS CORPORATION; 14201 nw 60th ave; miami lakes FL 33014
• MDR Report Key: 6644772
• Report Number: 9616099-2017-01173
• Device Sequence Number: 16347640
• Product Code: LIT
• UDI-Device Identifier: 20705032069851
• UDI-Public: 20705032069851
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K971010
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: company representative,foreig
• Initial Reporter Occupation: Health Professional
• Type of Report: Initial
• Report Date (Section B): 06/15/2017

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 Date: 05/31/2017
• Device Model Number: 48004004S
• Device Catalogue Number: 48004004S
• Device Lot Number: 17029240
• Was Device Available for Evaluation?: No
• Distributor Facility Aware Date: 05/29/2017
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 05/29/2017
• Initial Report FDA Received Date: 06/15/2017
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1