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U.S. Department of Health and Human Services

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

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BARD PERIPHERAL VASCULAR, INC. ATLAS GOLD PTA DILATATION CATHETER; PTA BALLOON DILATATION CATHETER Back to Search Results
Catalog Number ATG120144
Device Problems Inflation Problem (1310); Peeled/Delaminated (1454); Material Rupture (1546)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Date 06/22/2018
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 an angioplasty procedure, the pta balloon allegedly had difficulty inflating.There was no reported patient injury.
 
Manufacturer Narrative
Manufacturing review: the device history records have been reviewed and this lot met all release criteria.There was nothing found to indicate there was a manufacturing related cause for this event.This is the only complaint reported to date for this lot number and failure mode.Investigation summary: the device was returned for evaluation.A visual inspection found a peeled outer layer on the distal cone of the balloon, confirming the investigation for peeled outer layer.An inflation attempt was made and a pinhole rupture was noted on the distal cone.The balloon was unable to be fully inflated.Therefore, the investigation is confirmed for the reported inflation issue as well as for a pinhole rupture.The identified pinhole rupture likely was the cause of the inflation issue, as a rupture would not allow the device to adequately pressurize.Because the peeling outer layer was noted at the location of the rupture, it is unknown if the rupture caused or contributed to the peeling outer layer.The definitive root cause for the identified issues could not be determined based on the available information.Labeling review: the review of the ifu (instructions for use), indications, warnings, precautions, cautions, possible complications, and contraindications showed that the product labeling is adequate.
 
Event Description
It was reported that during an angioplasty procedure, the pta balloon allegedly had difficulty inflating.There was no reported patient injury.
 
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Brand Name
ATLAS GOLD PTA DILATATION CATHETER
Type of Device
PTA BALLOON DILATATION CATHETER
Manufacturer (Section D)
BARD PERIPHERAL VASCULAR, INC.
1625 w 3rd st.
tempe AZ 85281
MDR Report Key7869084
MDR Text Key120102278
Report Number2020394-2018-01686
Device Sequence Number1
Product Code LIT
UDI-Device Identifier00801741060762
UDI-Public(01)00801741060762
Combination Product (y/n)N
PMA/PMN Number
K122984
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Type of Report Initial,Followup
Report Date 11/13/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/12/2018
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date05/25/2021
Device Catalogue NumberATG120144
Device Lot Number93SC0222
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/13/2018
Date Manufacturer Received11/07/2018
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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