MAUDE MDR 1600023

MDR report key
1600023
Report number
3005099803-2010-00687
Event key
0
Event type
3
Date of event
2010-01-19
Date received
2010-02-16
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
MR. CHARLES MONTGOMERY
Address
100 BOSTON SCIENTIFIC WAY MARLBOROUGH MA 01752 US
Phone
508-508-5086
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1RUSCH POLYFLEX STENT KITPROSTHESIS, TRACHEAL, EXPANDABLE, POLYMERICBOSTON SCIENTIFIC - MARLBOROUGHNYTM005702807028Y Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12010-02-1601. R

Event Narratives#

D

Patient 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A POLYFLEX AIRWAY STENT WAS USED DURING A BRONCHOSCOPY WITH STENT PLACEMENT PROCEDURE PERFORMED ON (B) (6) 2009 ((B) (6) MALE; WEIGHT UNKNOWN). ACCORDING TO THE COMPLAINANT, A POLYFLEX STENT WAS PLACED ON (B) (6) 2009 TO TREAT TRACHEOMALACIA. A CHECKUP HAS BEEN PERFORMED EVERY 3 MONTHS SINCE THE PROCEDURE TO RE-EXAMINE THE STENT. ON (B) (6) 2010, THE PATIENT REPORTED DIFFICULTY BREATHING. THE PHYSICIAN DISCOVERED THAT THE DISTAL PORTION OF THE STENT HAD COLLAPSED. IN ADDITION, A SMALL FRACTURE OR HOLE WAS SEEN IN THE STENT WALL. THE STENT WAS REMOVED LATER THAT DAY. THE PATIENT WAS REPORTED TO BE DOING WELL AND WAS DISCHARGED THE NEXT DAY. ANOTHER STENT HAS NOT YET BEEN IMPLANTED. BEFORE IMPLANTING ANOTHER STENT THE PHYSICIAN WANTS TO ALLOW THE GRANULATION TISSUE TIME TO HEAL AND THE BACTERIAL COLONIZATION TO DECREASE. THE PHYSICIAN PLANS TO PERFORM A BRONCHOSCOPY AT A LATER DATE TO ASSESS THE PATIENT?S AIRWAYS. THE PHYSICIAN HAS DISCUSSED FURTHER STENTING OPTIONS WITH THE PATIENT. THE PHYSICIAN IS CONSIDERING IMPLANTING EITHER A DYNAMIC Y STENT OR AN ALVEOLUS/AERO HYBRID STENT. THE PATIENT?S TRACHEAL DIAMETER IS LARGE (ABOUT 20-22MM) AND THE PATIENT IS OBESE MAKING HIM A SOMEWHAT DIFFICULT CANDIDATE FOR RIGID PROCEDURES.

D

Patient 1

IT WAS REPORTED TO BOSTON SCIENTIFIC CORPORATION THAT A POLYFLEX AIRWAY STENT WAS USED DURING A BRONCHOSCOPY WITH STENT PLACEMENT PROCEDURE PERFORMED ON (B)(6) 2009 ((B)(6) MALE; WEIGHT UNKNOWN). ACCORDING TO THE COMPLAINANT, A POLYFLEX STENT WAS PLACED ON (B)(6) 2009 TO TREAT TRACHEOMALACIA. A CHECKUP HAS BEEN PERFORMED EVERY 3 MONTHS SINCE THE PROCEDURE TO RE-EXAMINE THE STENT. ON (B)(6) 2010, THE PATIENT REPORTED DIFFICULTY BREATHING. THE PHYSICIAN DISCOVERED THAT THE DISTAL PORTION OF THE STENT HAD COLLAPSED. IN ADDITION, A SMALL FRACTURE OR HOLE WAS SEEN IN THE STENT WALL. THE STENT WAS REMOVED LATER THAT DAY. THE PATIENT WAS REPORTED TO BE DOING WELL AND WAS DISCHARGED THE NEXT DAY. ANOTHER STENT HAS NOT YET BEEN IMPLANTED. BEFORE IMPLANTING ANOTHER STENT THE PHYSICIAN WANTS TO ALLOW THE GRANULATION TISSUE TIME TO HEAL AND THE BACTERIAL COLONIZATION TO DECREASE. THE PHYSICIAN PLANS TO PERFORM A BRONCHOSCOPY AT A LATER DATE TO ASSESS THE PATIENT'S AIRWAYS. THE PHYSICIAN HAS DISCUSSED FURTHER STENTING OPTIONS WITH THE PATIENT. THE PHYSICIAN IS CONSIDERING IMPLANTING EITHER A DYNAMIC Y STENT OR AN ALVEOLUS/AERO HYBRID STENT. THE PATIENT'S TRACHEAL DIAMETER IS LARGE (ABOUT 20-22MM) AND THE PATIENT IS OBESE MAKING HIM A SOMEWHAT DIFFICULT CANDIDATE FOR RIGID PROCEDURES.

N

Patient 1

(B) (4) THERAPY/NON-SURGICAL INTERVENTION, ADDITIONAL, PATIENT COMPLICATIONS. STENT DAMAGE. THE DEVICE HAS NOT BEEN RECEIVED FOR ANALYSIS. UPON RECEIPT AND COMPLETION OF THE FAILURE ANALYSIS OF THE COMPLAINT DEVICE, IF THERE IS ANY FURTHER RELEVANT INFORMATION FROM THAT REVIEW, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

N

Patient 1

ONLY THE STENT BODY WAS RETURNED FOR ANALYSIS. A VISUAL EVALUATION OF THE RETURNED DEVICE WAS CONDUCTED, AND REVEALED THAT THE STENT HAD A STRONG YELLOW DISCOLORATION. THE ELASTIC MATERIAL WAS NOT PROVIDED AND THE STENT BODY WAS HARD. THE FIBERS AT THE DISTAL END OF THE STENT WERE DESTROYED, AND A HOLE WAS OBSERVED IN THE INNER PART OF THE STENT, MOST LIKELY DUE TO EXCESSIVE FORCE USED DURING REMOVAL. BASED ON THE CONDITION OF THE RETURNED DEVICE, THE ROOT CAUSE CAN NOT BE DEFINITIVELY DETERMINED; HOWEVER THE DAMAGE TO THE STENT MAY BE DUE TO ANATOMICAL FACTORS. A REVIEW OF THE DEVICE HISTORY RECORD (DHR) WAS PERFORMED; NO ANOMALIES WERE NOTED THAT COULD BE RELATED TO THIS COMPLAINT. A LABELING REVIEW WAS PERFORMED, AND FROM THE INFORMATION AVAILABLE THIS DEVICE WAS USED PER THE DIRECTIONS FOR USE (DFU) / PRODUCT LABEL.