MAUDE MDR 1968538

MDR report key
1968538
Report number
1318694-2010-00014
Event key
0
Event type
3
Date received
2010-12-23
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
0
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
NICHELLE LAFLESH
Address
2880 MAIN ST. HOPKINTON NY 12965 US
Phone
315-315-3153
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1TEARDUCT CATHETERDACRYOCYSTOPLASTY CATHETERNUMED, INC.HNW352TD100TD-0044Y Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12010-12-230

Event Narratives#

D

Patient 1

BALLOON BURST.

N

Patient 1

LONGITUDINAL BALLOON BURST WAS CONFIRMED. THIS IS USUALLY CONSISTENT WITH INFLATION ABOVE THE RATED BURST PRESSURE, HOWEVER, THE REPORT STATES THAT IT BURST RIGHT AT THE RATED BURST PRESSURE. THE CATHETER IS RATED FOR 14ATM. THE DEVICE FROM THE CONTROLLED INVENTORY WAS TESTED FOR RATED BURST PRESSURE. IT BURST AT 18ATM WHICH IS WELL ABOVE THE LABELED RATED BURST PRESSURE. NO CONCLUSION CAN BE DRAWN.