MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-06-23 for DISTAFLO MINI-CUFF BYPASS GRAFT DFX8006SC manufactured by Bard Peripheral Vascular, Inc..
[48853258]
No device, no medical records, or no medical images have been made available to the manufacturer. As the lot number for the device was provided, a review of the device history records is currently being performed. The device has not been returned to the manufacturer for evaluation. The investigation of the reported event is currently underway. The information provided by bard represents all of the known information at this time. Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bard. Not returned.
Patient Sequence No: 1, Text Type: N, H10
[48853259]
It was reported that during removal of the beading from the vascular graft, the graft allegedly tore. It was further reported that the torn section of the graft was removed, a second anastomosis site was made, and the remainder of the graft was used to complete the procedure. There was no reported impact or consequence to the patient.
Patient Sequence No: 1, Text Type: D, B5
[54095119]
Manufacturing review: the device history records have been reviewed with special attention to the subassemblies, material review reports, raw material testing, manufacturing process, and quality control inspection. This lot met all release criteria. There was nothing found to indicate there was a manufacturing related cause for this event. This is the only complaint that has been reported for this corporate lot number to date. Visual inspection: the three segments had two blue lines running down the length of the graft and carbon inner lining, thus identifying them as bard products. The first segment measured approximately 45. 0cm in length. No suture holes, tears or rips were identified. The beading was intact throughout the entire length of the segment. The second segment measured approximately 13. 6cm in length. No suture holes, tears, or rips were identified throughout the length of the segment. The beading was intact throughout the entire length of the segment. The third segment measured approximately 2. 3cm in length. Partial circumferential tears were noted along the beading track of the returned segment. The beading was peeled along the whole segment. No kinks, indentations or abrasions were found. Both ends of the returned segment were noted to have uneven cuts. The cuff portion of the graft was not returned. Functional/performance evaluation: no functional/performance evaluation was performed. Medical records review: medical records were not provided; therefore, a review could not be performed. Image/photo review: image/photo review: images/photos were not provided; therefore, a review could not be performed. Conclusion: the device was returned. The investigation is confirmed for torn material, as partial circumferential tears were observed along the beading track of the returned segment. It is unknown if procedural issues contributed to the reported event. Based on the available information, the definitive root cause is unknown. Labeling review: the current ifu states: precautions: when removing the external spiral support (beading) of the distaflo? Graft, the beading must be removed slowly and at a 90? Angle to the graft. Rapid unwinding and /or removal at less than a 90? Angle may result in graft damage. Do not use surgical blades or sharp, pointed instruments to remove the beading as this may damage the graft wall. If damage occurs, that segment of the graft should not be used. The information provided by bard represents all of the known information at this time. Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bard.
Patient Sequence No: 1, Text Type: N, H10
[54095120]
It was reported that during removal of the beading from the vascular graft, the graft allegedly tore. It was further reported that the torn section of the graft was removed, a second anastomosis site was made, and the remainder of the graft was used to complete the procedure. There was no reported impact or consequence to the patient.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2020394-2016-00564 |
| MDR Report Key | 5746554 |
| Date Received | 2016-06-23 |
| Date of Report | 2016-05-30 |
| Date of Event | 2016-05-27 |
| Date Mfgr Received | 2016-08-10 |
| Device Manufacturer Date | 2015-11-30 |
| Date Added to Maude | 2016-06-23 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | JUDITH LUDWIG |
| Manufacturer Street | 1625 W 3RD ST. |
| Manufacturer City | TEMPE AZ 85281 |
| Manufacturer Country | US |
| Manufacturer Postal | 85281 |
| Manufacturer Phone | 4803032689 |
| Manufacturer G1 | BARD PERIPHERAL VASCULAR, INC. |
| Manufacturer Street | 1625 W 3RD ST. |
| Manufacturer City | TEMPE AZ 85281 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 85281 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | DISTAFLO MINI-CUFF BYPASS GRAFT |
| Generic Name | EPTFE VASCULAR GRAFT |
| Product Code | DYF |
| Date Received | 2016-06-23 |
| Returned To Mfg | 2016-07-12 |
| Catalog Number | DFX8006SC |
| Lot Number | VTZK0777 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BARD PERIPHERAL VASCULAR, INC. |
| Manufacturer Address | 1625 W 3RD ST. TEMPE AZ 85281 US 85281 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2016-06-23 |