BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    GELSOFT

    MDR report key: 8734316 · Received June 26, 2019

    Report

    Report Number
    9612515-2019-00010
    Event Type
    Malfunction
    Date Received
    June 26, 2019
    Date of Event
    May 2, 2019
    Report Date
    June 25, 2019
    Manufacturer
    VASCUTEK LTD
    Product Code
    MAL
    UDI-DI
    05037881110455
    PMA / PMN Number
    P890045/S1
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GM
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 0

    PATIENT CODE: 2692 - NO KNOWN IMPACT OR CONSEQUENCE TO PATIENT. DEVICE CODE: 1601 - STRETCHED (PROBLEM ASSOCIATED WITH AN INCREASE OR ELONGATION IN A MATERIAL DIMENSION). METHOD CODE: 4109 - HISTORICAL DATA ANALYSIS. 4110 - TREND ANALYSIS. 4114 - DEVICE NOT RETURNED. 3331 - ANALYSIS OF PRODUCTION RECORDS. RESULT CODE: 4247 - APPROPRIATE TERM / CODE NO AVAILABLE. CONCLUSION CODE: 22 - KNOWN INHERENT RISK OF DEVICE. A REVIEW OF MANUFACTURING AND QC RECORDS CONFIRMED THAT THE DEVICE WAS MANUFACTURED TO SPECIFICATION. WITHOUT THE RETURN OF THE GRAFT FOR ANALYSIS VASCUTEK LTD ARE UNABLE TO DETERMINE A ROOT CAUSE FOR THIS EVENT. HOWEVER FROM A REVIEW OF CLINICAL PAPERS AND THE DEVICE IFU IT HAS BEEN NOTED THAT DILATATION IS A KNOWN AND EXPECTED COMPLICATION OF THIS TYPE OF PROCEDURE DUE TO THE KNITTED STRUCTURE OF THE GRAFT. THE PERCENTAGE OF DILATATION VARIES SIGNIFICANTLY THROUGHOUT LITERATURE. (B)(4). ON THIS BASIS VASCUTEK NOW CONSIDERS THIS COMPLAINT CLOSED. HOWEVER THIS ISSUE WILL BE TRACKED AND TRENDED AS PART OF THE ROUTINE COMPLAINTS MONITORING AND REPORTING PROCESS. IF AN ADVERSE TREND DEVELOPS ACTIONS WILL BE TAKEN AT THAT TIME.

    Description of Event or Problem · 0

    THE EVENT, WHICH OCCURRED IN (B)(6) HOSPITAL, GERMANY WAS REPORTED TO VASCUTEK LTD AS FOLLOWS: THE PATIENT RECEIVED 3 BIFURCATED GRAFTS CREATING A SO-CALLED OCTOPUS GRAFT. DURING CT FOLLOW UP THE PHYSICIAN OBSERVED AN INCREASE OF THE DIAMETER OF THE MAIN GRAFT BODY TO 19.5MM. THIS COMPLAINT IS RELATED TO COMPLAINTS (B)(4) (MFR # 9612515-2019-00013) AND (B)(4) (MFR # 9612515-2019-000009). THIS REPORT WAS UPDATED TO REFLECT CORRECT MFR NUMBER FOR COMPLAINT (B)(4).

    Additional Manufacturer Narrative · 1

    (B)(4). A REVIEW OF MANUFACTURING AND QC RECORDS CONFIRMED THAT THE DEVICE WAS MANUFACTURED TO SPECIFICATION. WITHOUT THE RETURN OF THE GRAFT FOR ANALYSIS VASCUTEK LTD ARE UNABLE TO DETERMINE A ROOT CAUSE FOR THIS EVENT. HOWEVER FROM A REVIEW OF CLINICAL PAPERS AND THE DEVICE IFU IT HAS BEEN NOTED THAT DILATATION IS A KNOWN AND EXPECTED COMPLICATION OF THIS TYPE OF PROCEDURE DUE TO THE KNITTED STRUCTURE OF THE GRAFT. THE PERCENTAGE OF DILATATION VARIES SIGNIFICANTLY THROUGHOUT LITERATURE. IN THE LAST FIVE YEARS FROM 2014 TO 2019 VASCUTEK LTD HAS RECEIVED A TOTAL OF 8 COMPLAINTS, FOR KNITTED GRAFTS WHERE DILATATION OF THE GRAFT HAS BEEN REPORTED AS AN ISSUE. SALES FOR THIS PERIOD AND GRAFT TYPE IS (B)(4) UNITS. THIS GIVES A VERY LOW INCIDENT RATE OF (B)(4). AS DILATATION OF KNITTED GRAFTS IS INHERENT AND EXPECTED THERE IS NO COMMON INDUSTRY INCIDENT RATE FOR COMPARISON. ON THIS BASIS VASCUTEK NOW CONSIDERS THIS COMPLAINT CLOSED. HOWEVER THIS ISSUE WILL BE TRACKED AND TRENDED AS PART OF THE ROUTINE COMPLAINTS MONITORING AND REPORTING PROCESS. IF AN ADVERSE TREND DEVELOPS ACTIONS WILL BE TAKEN AT THAT TIME.

    Description of Event or Problem · 1

    THE EVENT, WHICH OCCURRED IN (B)(6) WAS REPORTED TO VASCUTEK LTD AS FOLLOWS: THE PATIENT RECEIVED 3 BIFURCATED GRAFTS CREATING A SO-CALLED OCTOPUS GRAFT. DURING CT FOLLOW UP THE PHYSICIAN OBSERVED AN INCREASE OF THE DIAMETER OF THE MAIN GRAFT BODY TO 19.5MM. THIS COMPLAINT IS RELATED TO COMPLAINTS (B)(4) (MFR # 9612515-2019-00008) AND (B)(4) (MFR # 9612515-2019-000009).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    530627 GELSOFT GELSOFT BIFURCATE MAL VASCUTEK LTD 375738 8500 05037881110455

    Patients

    Seq Age Sex Outcome Treatment
    1