FDA Adverse Event Malfunction Summary report: N

LUNDERQUIST EXTRA-STIFF CURVED EXCHANGE SUPPORT WIRE GUIDE

MDR report key: 23665669 · Received November 27, 2025

Report

Report Number
3002808486-2025-00250
Event Type
Malfunction
Date Received
November 27, 2025
Date of Event
November 18, 2025
Report Date
January 29, 2026
Manufacturer
WILLIAM COOK EUROPE
Product Code
DQX
UDI-DI
00827002453531
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NL
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE MANUFACTURER'S REFERENCE NUMBER: (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). AFTER INVESTIGATION THE EVENT IS NO LONGER CONSIDERED REPORTABLE AS THE DEVICE DID NOT MALFUNCTION AND IS NOT LIKELY TO CAUSE OR CONTRIBUTE TO DEATH OR SERIOUS INJURY IF THE MALFUNCTION WERE TO RECUR. SUMMARY OF INVESTIGATIONAL FINDINGS: THIS COMPLAINT HANDLES TWO SIMILAR CASES WHERE TWO DIFFERENT PATIENTS WAS EXPOSED TO A TSCMG-35-260-7-LES (SAME LOT IN BOTH CASES). WHILE CLEANING THE LUNDERQUIST DURING EVAR PROCEDURE, THERE APPEARS TO BE GREY SLUDGE LEFT BEHIND. COLLEAGUES HAVE CONFIRMED THAT THIS WAS ALSO NOTICED IN PREVIOUS PROCEDURES. ON INSPECTION OF THE WIRE GUIDE IT LOOKS LIKE THERE ARE PATCHES WHERE THE COATING IS GONE AND THE WIRE GUIDE FEELS ROUGH OR RIGID. THEY USED THE WIRE THE ENTIRE PROCEDURE SO NO NEED FOR ADDITIONAL WIRES. NO ADVERSE EFFECT WAS REPORTED ON PATIENT. THE COMPLAINT REPORTED BY THE USER WAS CONFIRMED. THE COMPLAINT IS CONFIRMED BASED ON VISUAL/AND/OR FUNCTIONAL INSPECTION. THE WIRE GUIDE WAS RETURNED FOR EVALUATION. THE DEVICE EVALUATION DETERMINED THE FOLLOWING: THE DEVICE EVALUATION CONFIRMED SEVERAL AREAS WITH PEELED OFF COATING. CONSEQUENTLY, THE ADHESION OF THE COATING WAS TESTED AND FOUND INSUFFICIENT. THEREFORE, APPROPRIATE ACTIONS HAVE BEEN TAKEN AND RELEVANT PERSONNEL WERE NOTIFIED. 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. THE REVIEW OF THE RELEVANT MANUFACTURING RECORDS CONFIRMS THE FAILURE HAS NOT PREVIOUSLY OCCURRED FOR THIS MANUFACTURING LOT. THERE IS NO EVIDENCE TO SUGGEST THAT THE USER DID NOT FOLLOW THE INSTRUCTIONS FOR USE AND/OR LABEL. A DEFINITIVE CAUSE WAS IDENTIFIED, AS THE ADHESION OF THE COATING TO THE WIRE GUIDE WAS FOUND INSUFFICIENT. AN INTERNAL ACTION IS NOT DEEMED NECESSARY AS THE COMPLAINT FALLS WITHIN THE SCOPE OF AN ONGOING INTERNAL ACTION REGARDING "COATING PEELS OFF ON LES WIRE". 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: WHILE CLEANING THE LUNDERQUIST DURING EVAR PROCEDURE, THERE APPEARS TO BE GREY SLUDGE LEFT BEHIND. COLLEAGUES HAVE CONFIRMED THAT THIS WAS ALSO NOTICED IN PREVIOUS PROCEDURES. ON INSPECTION OF THE WIRE GUIDE IT LOOKS LIKE THERE ARE PATCHES WHERE THE COATING IS GONE AND THE WIRE GUIDE FEELS ROUGH OR RIGID. THE WIRE SEEMS TO HAVE SCRAPINGS OF THE TEFLON COATING COMING OFF. THE WIRE WAS USED THE ENTIRE PROCEDURE SO NO NEED FOR ADDITIONAL WIRES.

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
2729023 LUNDERQUIST EXTRA-STIFF CURVED EXCHANGE SUPPORT WIRE GUIDE DQX WIRE, GUIDE, CATHETER DQX WILLIAM COOK EUROPE G45353 E4753105 00827002453531

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown