FDA Adverse Event Malfunction Summary report: N

ZELANTEDVT CLOTHUNTER

MDR report key: 19778434 · Received July 18, 2024

Report

Report Number
2124215-2024-43159
Event Type
Malfunction
Date Received
July 18, 2024
Date of Event
June 14, 2024
Report Date
September 20, 2024
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
QEW
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

E1 - INITIAL REPORTER FACILITY NAME: (B)(6). DEVICE EVALUATED BY MFR: THE COMPLAINT DEVICE WAS RECEIVED FOR PRODUCT ANALYSIS. VISUAL INSPECTION OF THE DEVICE REVEALED MULTIPLE SHAFT KINKS AND AN UNKNOWN NON-BSC GUIDEWIRE STUCK INSIDE THE DEVICE. AN UNKNOWN NON-BSC .035 GUIDEWIRE WAS RECEIVED STUCK INSIDE THE DEVICE. THE DEVICE WAS FLUSHED AND THE GUIDEWIRE WAS OBSERVED TO HAVE A HYDROPHILIC COATING THAT WAS ABLE TO BE REMOVED ONCE PROPERLY LUBRICATED. INSPECTION OF THE RETURNED DEVICE REVEALED MULTIPLE SHAFT KINKS; HOWEVER, THE KINKS DID NOT DISRUPT GUIDEWIRE INSERTION OR REMOVAL. THE COMPLAINT WAS NOT CONFIRMED FOR GUIDEWIRE INSERTION OR REMOVAL ISSUES; HOWEVER, SHAFT DAMAGE WAS CONFIRMED.

Additional Manufacturer Narrative · 0

E1 - INITIAL REPORTER FACILITY NAME: (B)(6) HOSPITAL. E1 - INITIAL REPORTER ADDRESS 1:(B)(6).

Additional Manufacturer Narrative · 0

E1 - INITIAL REPORTER FACILITY NAME: (B)(6) HOSPITAL

Description of Event or Problem · 0

IT WAS REPORTED THAT THE GUIDEWIRE WAS STUCK IN THE CATHETER. THE TARGET LESION WAS LOCATED IN THE POPLITEAL AND FEMORAL VEIN. AN ANGIOJET ZELANTE CATHETER WAS SELECTED FOR VENOUS THROMBOSIS REMOVAL PROCEDURE. DURING THE PROCEDURE, IT WAS NOTED THAT THE GUIDEWIRE WAS STUCK IN THE CATHETER AND COULD NOT BE PULLED OUT. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO COMPLICATIONS WERE REPORTED AND THE PATIENT WAS STABLE POST-PROCEDURE. IT WAS FURTHER REPORTED THAT THE 80% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND MODERATELY CALCIFIED POPLITEAL AND FEMORAL VEIN. FURTHERMORE, THE DEVICE WAS REMOVED FROM THE PATIENT'S BODY BY SIMPLY PULLING IT OUT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE GUIDEWIRE WAS STUCK IN THE CATHETER. THE TARGET LESION WAS LOCATED IN THE POPLITEAL AND FEMORAL VEIN. AN ANGIOJET ZELANTE CATHETER WAS SELECTED FOR VENOUS THROMBOSIS REMOVAL PROCEDURE. DURING THE PROCEDURE, IT WAS NOTED THAT THE GUIDEWIRE WAS STUCK IN THE CATHETER AND COULD NOT BE PULLED OUT. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO COMPLICATIONS WERE REPORTED AND THE PATIENT WAS STABLE POST-PROCEDURE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE GUIDEWIRE WAS STUCK IN THE CATHETER. THE TARGET LESION WAS LOCATED IN THE POPLITEAL AND FEMORAL VEIN. AN ANGIOJET ZELANTE CATHETER WAS SELECTED FOR VENOUS THROMBOSIS REMOVAL PROCEDURE. DURING THE PROCEDURE, IT WAS NOTED THAT THE GUIDEWIRE WAS STUCK IN THE CATHETER AND COULD NOT BE PULLED OUT. THE PROCEDURE WAS COMPLETED WITH ANOTHER OF THE SAME DEVICE. NO COMPLICATIONS WERE REPORTED AND THE PATIENT WAS STABLE POST-PROCEDURE. IT WAS FURTHER REPORTED THAT THE 80% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TORTUOUS AND MODERATELY CALCIFIED POPLITEAL AND FEMORAL VEIN. FURTHERMORE, THE DEVICE WAS REMOVED FROM THE PATIENT'S BODY BY SIMPLY PULLING IT OUT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1753420 ZELANTEDVT CLOTHUNTER PERIPHERAL MECHANICAL THROMBECTOMY WITH ASPIRATION QEW BOSTON SCIENTIFIC CORPORATION 45027 0033067377

Patients

Seq Age Sex Outcome Treatment
1 71 YR Female