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U.S. Department of Health and Human Services

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

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BARD PERIPHERAL VASCULAR, INC. ATLAS PTA DILATATION CATHETER; PTA BALLOON DILATATION CATHETER Back to Search Results
Model Number AT75124
Device Problems Crack (1135); Deflation Problem (1149); Retraction Problem (1536)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Date 08/20/2018
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.(expiry date: (b)(6) 2021).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 in the right subclavian vein, the pta balloon allegedly had difficulty deflating.It was further reported that the balloon had issues retracting through the sheath.No further treatment was needed.There was no reported patient injury.
 
Manufacturer Narrative
H10: manufacturing review: the device history records were reviewed with special attention to the raw materials, subassemblies, manufacturing process and quality control testing.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 and the user's introducer sheath were returned for evaluation.A visual inspection found the cracks in the inflation luer of the device.At attempt was made to inflate the device and leaking was noted through the cracks in the inflation luer, preventing the device from being fully inflated or holding pressure.Therefore, the investigation is inconclusive for the reported deflation issue as the balloon was unable to be fully inflated due to the cracks in the luer.However, the investigation is confirmed for cracks in the inflation luer leading to inflation issues.The investigation is also confirmed for the reported retraction issue as the distal tip of the returned sheath was buckled and damaged.It is possible that the cracks in the inflation luer contributed to the reported deflation issue, as the cracks resulted in an inflation issue during functional testing.It is also possible that a deflation issue would lead to retraction issues through the sheath.However, the definitive root cause for the reported or 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.H10: d4 (expiry date: 06/2021) h6 (trending device code: 1310 - inflation issue).
 
Event Description
It was reported that during an angioplasty procedure in the right subclavian vein, the pta balloon allegedly had difficulty deflating.It was further reported that the balloon had issues retracting through the sheath.No further treatment was needed.There was no reported patient injury.
 
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Brand Name
ATLAS 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 Key7877571
MDR Text Key120535809
Report Number2020394-2018-01700
Device Sequence Number1
Product Code LIT
UDI-Device Identifier00801741062407
UDI-Public(01)00801741062407
Combination Product (y/n)N
PMA/PMN Number
K120971
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Type of Report Initial,Followup
Report Date 01/03/2019
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 Model NumberAT75124
Device Catalogue NumberAT75124
Device Lot NumberGFCT2212
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/05/2018
Initial Date Manufacturer Received 08/20/2018
Initial Date FDA Received09/14/2018
Supplement Dates Manufacturer Received12/07/2018
Supplement Dates FDA Received01/03/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Patient Age77 YR
Patient Weight97
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