FDA Adverse Event Malfunction Summary report: N

SYNERGY BALLOON DILATATION CATHETER

MDR report key: 4132926 · Received October 1, 2014

Report

Report Number
2134265-2014-05998
Event Type
Malfunction
Date Received
October 1, 2014
Report Date
September 8, 2014
Manufacturer
BOSTON SCIENTIFIC - GALWAY
Product Code
LIT
PMA / PMN Number
K993305
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). DEVICE EVALUATED BY MANUFACTURER: IT IS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION; THEREFORE A FAILURE ANALYSIS OF THE COMPLAINT DEVICE COULD NOT BE COMPLETED. A REVIEW OF THE BATCH HISTORY, HISTORICAL TRENDING, AND SIMILAR COMPLAINT TRENDING REVIEW FOR THE PRODUCT FAMILY WILL BE CONDUCTED. IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED. LITERATURE CITATION: "PROSPECTIVE, RANDOMIZED STUDY OF CUTTING BALLOON ANGIOPLASTY VERSUS CONVENTIONAL BALLOON ANGIOPLASTY FOR THE TREATMENT OF HEMODIALYSIS ACCESS STENOSES; JOURNAL OF VASCULAR SURGERY; 2014" (B)(4).

Description of Event or Problem · 1

REPORTED VIA JOURNAL ARTICLE: IT WAS REPORTED THAT BALLOON RUPTURE OCCURRED. IN A STUDY COMPARING RATES OF PATENCY ACHIEVED BY CUTTING AND CONVENTIONAL BALLOON ANGIOPLASTY TO TREAT HEMODIALYSIS ACCESS STENOSES, A BALLOON RUPTURE DURING INFLATION OCCURRED IN THE CONVENTIONAL BALLOON ANGIOPLASTY GROUP.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
613281 SYNERGY BALLOON DILATATION CATHETER CATHETER, ANGIOPLASTY, PERIPHERAL, TRANSLUMINAL LIT BOSTON SCIENTIFIC - GALWAY UNK425

Patients

Seq Age Sex Outcome Treatment
1