FDA Adverse Event Malfunction Summary report: N

LUNDERQUIST EXTRA-STIFF STRAIGHT EXCHANGE SUPPORT WIRE GUIDE

MDR report key: 22210391 · Received June 16, 2025

Report

Report Number
3002808486-2025-00134
Event Type
Malfunction
Date Received
June 16, 2025
Date of Event
May 7, 2025
Report Date
November 18, 2025
Manufacturer
WILLIAM COOK EUROPE
Product Code
DQX
UDI-DI
00827002314535
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CN
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

MANUFACTURERS REF # (B)(4). G4) SIMILAR TO DEVICE MARKETED UNDER 510(K)/PMA: K220137. INVESTIGATION IS STILL IN PROGRESS THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Additional Manufacturer Narrative · 0

MANUFACTURERS REF# (B)(4). INVESTIGATION IS STILL IN PROGRESS. THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Additional Manufacturer Narrative · 0

MANUFACTURER¿S REF# (B)(4). AFTER INVESTIGATION THE EVENT IS NO LONGER CONSIDERED REPORTABLE TO FDA AS THE DEVICE MALFUNCTION IS UNLIKELY TO CAUSE OR CONTRIBUTE TO DEATH OR SERIOUS INJURY IF THE MALFUNCTION WERE TO RECUR. SUMMARY OF INVESTIGATIONAL FINDINGS: TWO WIRE GUIDES FAIL TO PASS THROUGH THE LESION. A THIRD WIRE GUIDE WAS USED TO COMPLETE THE PROCEDURE. THE COMPLAINT REPORTED BY THE USER WAS CONFIRMED BASED ON CUSTOMER AND/OR SALES REPRESENTATIVE TESTIMONY, AS THE COMPLAINT CLAIM MAY HAVE BEEN INFLUENCED BY CLINICAL SETTINGS THAT CANNOT BE REPLICATED. THE ENTIRE DEVICES WERE RETURNED FOR EVALUATION. THE DEVICE EVALUATION DETERMINED THE FOLLOWING: TWO USED WIRE GUIDES WERE RETURNED INSIDE THE WIRE GUIDE HOLDERS. REPORTEDLY, THE TIP OF BOTH WIRE GUIDES HAD BEEN ALTERED PRIOR TO USE, BUT UPON RETURN ONLY ONE OF THE WIRE GUIDES HAD A CURVED TIP. BASED ON THE ANALYSIS OF THE RETURNED WIRE GUIDES THE EXACT REASON FOR THEM NOT TO PASS THE LESION CANNOT BE DETERMINED. A REVIEW OF THE MANUFACTURING RECORDS AND/OR SPECIFICATIONS DID NOT REVEAL ANY DISCREPANCIES/NONCONFORMANCES THAT COULD HAVE CONTRIBUTED TO THIS COMPLAINT ISSUE. THE INVESTIGATION CONCLUDES THE COMPLAINT DEVICE WAS MANUFACTURED TO SPECIFICATION. THERE IS NO EVIDENCE TO SUGGEST THAT THE USER DID NOT FOLLOW THE INSTRUCTIONS FOR USE OR LABEL. A DEFINITIVE CAUSE COULD NOT BE DETERMINED FROM THE INVESTIGATION. POSSIBLE CAUSES MAY BE RELATED TO THE LESION AND/OR TO CURVING THE FLEXIBLE WIRE GUIDE TIP. AN INTERNAL ACTION IS NOT DEEMED NECESSARY AT THIS TIME. TRENDING WILL MONITOR IF ANY FUTURE ACTIONS ARE REQUIRED. AFTER CONSIDERING THIS EVENT THE RISK ASSOCIATED WITH THE USE OF THIS DEVICE IS STILL DEEMED ADEQUATE. COOK MEDICAL WILL CONTINUE TO MONITOR FOR SIMILAR EVENTS. THIS REPORT IS REQUIRED BY THE FDA UNDER 21 CFR PART 803. THIS REPORT IS BASED ON UNCONFIRMED INFORMATION SUBMITTED BY OTHERS. NEITHER THE SUBMISSION OF THIS REPORT NOR ANY STATEMENT MADE IN IT IS INTENDED TO BE AN ADMISSION THAT ANY COOK DEVICE IS DEFECTIVE OR MALFUNCTIONED; THAT A DEATH OR SERIOUS INJURY OCCURRED; OR THAT ANY COOK DEVICE CAUSED OR CONTRIBUTED TO; OR IS LIKELY TO CAUSE OR CONTRIBUTE TO A DEATH OR SERIOUS INJURY IF A MALFUNCTION OCCURRED.

Description of Event or Problem · 0

DESCRIPTION OF EVENT ACCORDING TO INITIAL REPORTER: DURING THE PROCEDURE, THE WIRE GUIDE FAILS TO PASS THROUGH THE LESION. REPLACEMENT OF THE WIRE GUIDE TO CONTINUE THE PROCEDURE.

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED 23JUN2025: THE GUIDE WERE USED FOR CORONARY ANGIOPLASTY. THE WIRE GUIDE PASSED THROUGH THE ARTERY DURING THE PROCEDURE, THE RIGHT CORONARY CHRONIC OCCLUSION WAS COMPLETE AND THE WIRE GUIDE FAILED TO PASS THROUGH THE LESION. THE TIP OF THE WIRE GUIDES WAS ALTERED PRIOR TO USE.

Description of Event or Problem · 0

NO ADDITIONAL INFORMATION REGARDING THE PATIENT AND/OR EVENT HAS BEEN RECEIVED SINCE THE PREVIOUS MEDWATCH REPORT WAS SENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
242111 LUNDERQUIST EXTRA-STIFF STRAIGHT EXCHANGE SUPPORT WIRE GUIDE DQX WIRE, GUIDE, CATHETER DQX WILLIAM COOK EUROPE G31453 E4641861 00827002314535

Patients

Seq Age Sex Outcome Treatment
1 41 YR Male