FDA Adverse Event Injury Summary report: N

APERTA NSE PTA BALLOON DILATATION CATHETER

MDR report key: 22563427 · Received July 22, 2025

Report

Report Number
3007835716-2025-00078
Event Type
Injury
Date Received
July 22, 2025
Date of Event
June 24, 2025
Manufacturer
GOODMAN CO., LTD.
Product Code
PNO
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

DEVICE EVALUATION IS NOT COMPLETED YET, THEREFORE WE DID NOT DETERMINE THAT CAUSE OF THIS EVENT. THIS IS AN INITIAL REPORT, INVESTIGATION RESULT WILL BE DESCRIBED IN A FOLLOW-UP REPORT.

Additional Manufacturer Narrative · 0

THE PRODUCT WAS NOT RETURNED FOR INVESTIGATION, AND THE INVESTIGATION WAS UNABLE TO DETERMINE THE DEFINITIVE CAUSE OF THE REPORTED PROBLEM. NO ABNORMALITIES WERE FOUND ON THE PRODUCTION RECORDS. THE BIOLOGICAL SAFETY OF THE PRODUCT IN QUESTION HAS BEEN CONFIRMED THROUGH EVALUATION TESTING, AND IT HAS BEEN CONFIRMED THAT THE STERILIZATION PROCESS WAS PROPERLY MANAGED. THE RESULTS OF THE INVESTIGATION SUGGEST THAT THE PRODUCT IS UNLIKELY TO CAUSE AN ALLERGIC REACTION, BUT AS THE ACTUAL PRODUCT WAS NOT PROVIDED AND AN ON-SITE INSPECTION WAS NOT POSSIBLE, THE CAUSE HAS NOT IDENTIFIED. NO ADDITIONAL COMPLICATIONS HAVE BEEN REPORTED, AND THE PATIENT'S POSTOPERATIVE CONDITION IS GOOD. THE INSTRUCTIONS FOR USE (IFU) CONTAIN INFORMATION ON GENERAL USAGE, WARNINGS AND PRECAUTIONS RELATED TO THE DEVICE, AND POTENTIAL COMPLICATIONS AND OTHER EVENTS SIMILAR TO THIS EVENT. THIS REPORT DOES NOT IMPLY THAT ANYONE HAS ACKNOWLEDGED THAT THE PRODUCT DESCRIBED IN THIS REPORT IS DEFECTIVE.

Description of Event or Problem · 0

THERE HAS BEEN A REPORT OF A CASE SUSPECTED TO EXHIBIT ALLERGIC SYMPTOMS. DURING THE PROCEDURE, THE PATIENT DEVELOPED ITCHING IN THE RIGHT ANTERIOR CHEST AND A WHEAL WAS OBSERVED IN THE SAME AREA. AFTER THE PROCEDURE, THE PATIENT ALSO DEVELOPED ITCHING AND A WHEAL IN THE ABDOMEN AND BOTH THIGHS. THEN ANTI ALLERGIC DRUGS WAS ADMINISTERED, AFTER THAT THE PATIENT RECOVERED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1713345 APERTA NSE PTA BALLOON DILATATION CATHETER CATHETER, PERCUTANEOUS, CUTTING/SCORING PNO GOODMAN CO., LTD. AA18-05050040 ALDD24H008

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Other