FDA Adverse Event Malfunction Summary report: N

STERLING ES PTA BALLOON DILATATION CATHETER

MDR report key: 2022411 · Received March 17, 2011

Report

Report Number
2134265-2011-00945
Event Type
Malfunction
Date Received
March 17, 2011
Date of Event
February 22, 2011
Report Date
February 23, 2011
Manufacturer
BOSTON SCIENTIFIC - MAPLE GROVE
Product Code
LIT
PMA / PMN Number
K080982
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

DEVICE EVALUATED BY MFR: RETURNED PRODUCT ANALYSIS REVEALED DRIED BLOOD AND CONTRAST WERE PRESENT IN THE GUIDE WIRE LUMEN. THE BALLOON CATHETER WAS RETURNED IN A DEFLATED STATE. THE BALLOON WAS INSPECTED UNDER MAGNIFICATION. A PINHOLE WAS CONFIRMED IN THE BALLOON WALL < 1 MM FROM THE PROXIMAL SIDE OF THE DISTAL MARKERBAND. INSPECTION OF THE BALLOON PRESENTED NO IRREGULARITIES IN THE BALLOON MATERIAL OR THE RO MARKERS THAT COULD HAVE CONTRIBUTED TO THE DAMAGE. THERE IS NO EVIDENCE OF ANY MATERIAL OR MANUFACTURING DEFICIENCIES THAT COULD HAVE CONTRIBUTED TO THIS COMPLAINT. THE MANUFACTURING BATCH RECORD REVIEW CONFIRMED THAT THE DEVICE MET ALL MATERIAL, ASSEMBLY AND PERFORMANCE SPECIFICATIONS. THE MOST PROBABLE ROOT CAUSE IS OPERATIONAL CONTEXT AS DEVICE PERFORMANCE WAS LIMITED DUE TO ANATOMICAL/PROCEDURAL FACTORS. (B)(4).

Additional Manufacturer Narrative · 1

AGE AT TIME OF EVENT: (B)(6). (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY TREATMENT PROCEDURE, A BALLOON RUPTURE OCCURRED. THE 99% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TO SEVERELY CALCIFIED AND MODERATELY TORTUOUS RIGHT ANTERIOR TIBIAL ARTERY. A JOURNEY GUIDE WIRE WAS PLACED ACROSS THE LESION AND THE 2MM X 40MM STERLING BALLOON CATHETER WAS ADVANCED FOR PRE-DILATION. DURING THE FIRST INFLATION, THE BALLOON RUPTURED AT 2ATMS AND A LEAK WAS NOTED. THE DEVICE WAS EXCHANGED FOR A 2.5MM X 40MM STERLING BALLOON WHICH WAS INFLATED THREE TIMES. A 2.0MM X 15MM SPCB FLEXTOME CATHETER WAS THEN INSERTED AND DIFFICULTY WAS REPORTED WHILE ADVANCING TO THE LESION. DURING THE FIRST INFLATION, THE SPCB RUPTURED AT 2ATMS. ADDITIONAL DILATIONS WERE PERFORMED WITH THE 2.5MM X 40MM STERLING BALLOON AND ANOTHER 2.0 SPCB TO COMPLETE THE PROCEDURE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AND THE PATIENT'S STATUS IS GOOD.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY TREATMENT PROCEDURE, A BALLOON RUPTURE OCCURRED. THE 99% STENOSED TARGET LESION WAS LOCATED IN THE MODERATELY TO SEVERELY CALCIFIED AND MODERATELY TORTUOUS RIGHT ANTERIOR TIBIAL ARTERY. A JOURNEY GUIDE WIRE WAS PLACED ACROSS THE LESION AND THE 2MM X 40MM STERLING BALLOON CATHETER WAS ADVANCED FOR PRE-DILATION. DURING THE FIRST INFLATION, THE BALLOON RUPTURED AT 2ATMS AND A LEAK WAS NOTED. THE DEVICE WAS EXCHANGED FOR A 2.5MM X 40MM STERLING BALLOON WHICH WAS INFLATED THREE TIMES. A 2.0MM X 15MM SPCB FLEXTOME CATHETER WAS THEN INSERTED AND DIFFICULTY WAS REPORTED WHILE ADVANCING TO THE LESION. DURING THE FIRST INFLATION, THE SPCB RUPTURED AT 2ATMS. ADDITIONAL DILATIONS WERE PERFORMED WITH THE 2.5MM X 40MM STERLING BALLOON AND ANOTHER 2.0 SPCB TO COMPLETE THE PROCEDURE. THERE WERE NO PATIENT COMPLICATIONS REPORTED AND THE PATIENT'S STATUS IS GOOD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 STERLING ES PTA BALLOON DILATATION CATHETER CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL LIT BOSTON SCIENTIFIC - MAPLE GROVE H74939135204010 13990908

Patients

Seq Age Sex Outcome Treatment
1 6FR 10CM MEDIKIT INTRODUCER SHEATH| 2.0MM/1.5CM SPCB FLEXTOME CATHETER| 014/185CM JOURNEY GUIDE WIRE| ENCORE 26 INFLATION DEVICE