6X16MM SOLO PRO BALLOON CATHETER BC0616SP

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2011-04-12 for 6X16MM SOLO PRO BALLOON CATHETER BC0616SP manufactured by Acclarent Inc..

Event Text Entries

[1848947] This event occurred in one patient on (b)(6) 2011. Acclarent's vp of medical affairs was promptly notified, and the following information from the acting physician was noted: the patient was a (b)(6) male who was undergoing balloon sinuplasty under conscious sedation. A 6x16mm solo pro balloon catheter was inserted and inflated to 12 atm pressure. When the balloon deflated, brisk bleeding was noted from the front wall of the sphenoid sinus. The patient was given a general anesthetic and intubated. It appeared as if the balloon had dilated the sphenoid sinus ostia and a small part of bone on the inferior aspect of the front face of the sphenoid injured a branch of the sphenopalatine artery, which traverses this area. The area was cauterized and the bleeding stopped. The physician then treated the frontal sinuses with the same balloon catheter successfully. There were no further events at the time of surgery. The patient has since had three serious nosebleeds from the same side. He is undergoing an evaluation for a bleeding disorder. Two blood transfusions were needed. The physician was well trained, and has performed several cases per month since 2007. Until this event, he has not had any event of this kind. He felt the acclarent balloon technology functioned correctly, and no malfunction had occurred. In addition, he felt that the bleeding occurred as a result of possible blood vessel injury from a piece of bone or coagulopathy (condition related to slow clotting/bleeding). The customer complaint rate for bleeding associated with acclarent technology from (b)(6) 2010 to (b)(6) 2011 has been noted as 0. 001%. No negative trend has been identified at this time. We will continue to monitor and trend this failure mode and will continue to update the file with any additional information and provide subsequent reports if required.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number3005172759-2011-00002
MDR Report Key2067128
Report Source07
Date Received2011-04-12
Date of Report2011-04-06
Date of Event2011-03-10
Device Manufacturer Date2010-11-01
Date Added to Maude2011-04-26
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location3
Manufacturer ContactMARK BISHOP, VP
Manufacturer Street1525-B O'BRIEN DR.
Manufacturer CityMENLO PARK CA 94025
Manufacturer CountryUS
Manufacturer Postal94025
Manufacturer Phone6506875843
Single Use3
Remedial ActionOT
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name6X16MM SOLO PRO BALLOON CATHETER
Generic NameSOLO PRO
Product CodeKAM
Date Received2011-04-12
Model Number6X16MM
Catalog NumberBC0616SP
Lot Number101123E-CM
Device Expiration Date2012-11-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerACCLARENT INC.
Manufacturer AddressMENLO PARK CA US


Patients

Patient NumberTreatmentOutcomeDate
101. Required No Informationntervention 2011-04-12

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