FDA Adverse Event Malfunction Summary report: N

ASPIREX

MDR report key: 20034644 · Received August 22, 2024

Report

Report Number
3008439199-2024-00143
Event Type
Malfunction
Date Received
August 22, 2024
Date of Event
July 26, 2024
Report Date
September 27, 2024
Manufacturer
STRAUB MEDICAL AG
Product Code
DQX
UDI-DI
07640142811350
PMA / PMN Number
K220270
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H10: MANUFACTURING REVIEW: A MANUFACTURING REVIEW WAS CONDUCTED AND THERE WAS NOTHING FOUND TO INDICATE THERE WAS A MANUFACTURING RELATED CAUSE FOR THIS EVENT. INVESTIGATION SUMMARY: THE CATHETER WAS RETURNED FOR EVALUATION AND WAS PHYSICALLY INVESTIGATED. DURING PHYSICAL INVESTIGATION, THERE WAS A LOT OF BODY MATERIAL IN THE TIP OF THE CATHETER. THE TEST GUIDE WIRE WENT THROUGH WITHOUT ANY RESISTANCE. AFTER RUNNING IN THE WATER ASPIRATION TEST WAS PERFORMED AND NOMINAL ASPIRATION LEVEL WAS ACHIEVED. THE REPORTED MECHANICAL JAM CAN BE CONFIRMED, THE BREAK WAS NOT OBSERVED DURING PHYSICAL INVESTIGATION. THEREFORE, THE INVESTIGATION IS CONFIRMED FOR THE REPORTED MECHANICAL JAM ISSUE. A CLEAR ROOT CAUSE COULD NOT BE IDENTIFIED BUT A BLOCKAGE OF THE CATHETER REPRESENTS A KNOWN INHERENT RISK. LABELING REVIEW: AS THE REPORTED EVENT DID NOT ALLEGE A LABELING OR USE RELATED ISSUE, A LABELING REVIEW IS NOT REQUIRED. H11: D2B (QEW, DQX). H11: SECTION A THROUGH F ¿ THE INFORMATION PROVIDED BY BD REPRESENTS ALL 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 BD.

Additional Manufacturer Narrative · 0

H10: MANUFACTURING REVIEW: A MANUFACTURING REVIEW WAS CONDUCTED AND THERE WAS NOTHING FOUND TO INDICATE THERE WAS A MANUFACTURING RELATED CAUSE FOR THIS EVENT. INVESTIGATION SUMMARY: THE CATHETER WAS RETURNED FOR EVALUATION AND WAS PHYSICALLY INVESTIGATED. DURING PHYSICAL INVESTIGATION, THERE WAS A LOT OF BODY MATERIAL IN THE TIP OF THE CATHETER. THE TEST GUIDE WIRE WENT THROUGH WITHOUT ANY RESISTANCE. AFTER RUNNING IN THE WATER ASPIRATION TEST WAS PERFORMED AND NOMINAL ASPIRATION LEVEL WAS ACHIEVED. THE REPORTED MECHANICAL JAM CAN BE CONFIRMED, THE BREAK WAS NOT OBSERVED DURING PHYSICAL INVESTIGATION. THEREFORE, THE INVESTIGATION IS CONFIRMED FOR THE REPORTED MECHANICAL JAM ISSUE. A CLEAR ROOT CAUSE COULD NOT BE IDENTIFIED BUT A BLOCKAGE OF THE CATHETER REPRESENTS A KNOWN INHERENT RISK. LABELING REVIEW: AS THE REPORTED EVENT DID NOT ALLEGE A LABELING OR USE RELATED ISSUE, A LABELING REVIEW IS NOT REQUIRED. EXPIRY DATE: 08/2024. H11: SECTION A THROUGH F ¿ THE INFORMATION PROVIDED BY BD REPRESENTS ALL 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 BD.

Additional Manufacturer Narrative · 0

H10: AS THE LOT NUMBER FOR THE DEVICE WAS PROVIDED, A REVIEW OF THE DEVICE HISTORY RECORDS IS CURRENTLY BEING PERFORMED. THE RETURN OF THE SAMPLE IS PENDING. THE INVESTIGATION OF THE REPORTED EVENT IS CURRENTLY UNDERWAY. H10: D4 (EXPIRY DATE: 08/2024) H11: SECTION A THROUGH F ¿ THE INFORMATION PROVIDED BY BD REPRESENTS ALL 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 BD.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A THROMBECTOMY AND ATHERECTOMY PROCEDURE IN THE EXTERNAL ILIAC VEIN LESION VIA THE COMMON FEMORAL VEIN IPSILATERAL APPROACH, THE DEVICE ALLEGEDLY DID NOT CLUTCH OUT IN THE LESION. IT WAS FURTHER REPORTED THAT THE HELIX OF THE CATHETER ALLEGEDLY BROKE. REPORTEDLY, THE DEVICE WAS TAKEN OUT FROM THE PATIENT. THE PROCEDURE WAS COMPLETED USING ANOTHER DEVICE. THERE WAS NO REPORTED PATIENT INJURY.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A THROMBECTOMY AND ATHERECTOMY PROCEDURE IN THE EXTERNAL ILIAC VEIN LESION VIA THE COMMON FEMORAL VEIN IPSILATERAL APPROACH, THE DEVICE ALLEGEDLY DID NOT CLUTCH OUT IN THE LESION. IT WAS FURTHER REPORTED THAT THE HELIX OF THE CATHETER ALLEGEDLY BROKE. REPORTEDLY, THE DEVICE WAS TAKEN OUT FROM THE PATIENT. THE PROCEDURE WAS COMPLETED USING ANOTHER DEVICE. THERE WAS NO REPORTED PATIENT INJURY.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A THROMBECTOMY AND ATHERECTOMY PROCEDURE IN THE EXTERNAL ILIAC VEIN LESION VIA THE COMMON FEMORAL VEIN IPSILATERAL APPROACH, THE DEVICE ALLEGEDLY DID NOT CLUTCH OUT IN THE LESION. IT WAS FURTHER REPORTED THAT THE HELIX OF THE CATHETER ALLEGEDLY BROKE. REPORTEDLY, THE DEVICE WAS TAKEN OUT FROM THE PATIENT. THE PROCEDURE WAS COMPLETED USING ANOTHER DEVICE. THERE WAS NO REPORTED PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
953406 ASPIREX THROMBECTOMY & ATHERECTOMY DQX STRAUB MEDICAL AG 221064 07640142811350

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown