FDA Adverse Event Malfunction Summary report: N

ZEBRA

MDR report key: 25191804 · Received May 15, 2026

Report

Report Number
3015614-2026-00016
Event Type
Malfunction
Date Received
May 15, 2026
Date of Event
January 29, 2026
Report Date
May 15, 2026
Manufacturer
Q'APEL MEDICAL INC.
Product Code
DQY
UDI-DI
00857545008158
PMA / PMN Number
K240746
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Description of Event or Problem · 0

DURING A NEUROVASCULAR PROCEDURE, A ZEBRA 6 FR CATHETER (FG 01194-01, LOT FG250917C-02) WITH A SIM2 DISTAL CONFIGURATION WAS REPORTEDLY USED FOR VASCULAR ACCESS. DURING THE PROCEDURE, THE DISTAL SIM2 TIP SEGMENT REPORTEDLY SEPARATED FROM THE CATHETER. LIMITED PROCEDURAL DETAILS WERE AVAILABLE AT THE TIME OF MDR SUBMISSION DESPITE FOLLOW-UP ATTEMPTS WITH THE SALES REPRESENTATIVE AND PHYSICIAN. NO ADDITIONAL INFORMATION REGARDING THE EXACT PROCEDURAL SEQUENCE, RESISTANCE ENCOUNTERED, PATIENT OUTCOME, OR RETRIEVAL DETAILS WAS AVAILABLE. ONLY THE SEPARATED SIM2 DISTAL TIP SEGMENT WAS RETURNED FOR EVALUATION. RETURNED PRODUCT ANALYSIS IDENTIFIED COMPLETE SEPARATION OF THE DISTAL TIP SEGMENT WITH MEASURED ELONGATION OF APPROXIMATELY 4.5 CM RELATIVE TO NOMINAL MANUFACTURED LENGTH, CONSISTENT WITH SIGNIFICANT TENSILE LOADING PRIOR TO SEPARATION. NO EVIDENCE OF MANUFACTURING OR MATERIAL NONCONFORMANCE WAS IDENTIFIED IN THE RETURNED SEGMENT EVALUATION. THE OBSERVED DAMAGE MORPHOLOGY WAS CONSISTENT WITH MECHANICAL OVERSTRESS ENCOUNTERED DURING CLINICAL USE. AT THE TIME OF THIS REPORT, NO ADDITIONAL PATIENT INJURY INFORMATION HAD BEEN PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
372534 ZEBRA Catheter, percutaneous DQY Q'APEL MEDICAL INC. FG 01194-01 FG250917C-02 00857545008158

Patients

Seq Age Sex Outcome Treatment
1