IMPRA VASCULAR GRAFT 40S06

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional,study,use report with the FDA on 2017-02-14 for IMPRA VASCULAR GRAFT 40S06 manufactured by Bard Peripheral Vascular, Inc..

Event Text Entries

[67371879] 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. Clinical trial review: an av graft was placed in the right upper arm as a study conduit for a clinical trial. Approximately two weeks post graft placement, the patient presented with a seroma and drainage from the graft at the antecubital fossa level. The patient was scheduled for repair of the graft and excision of the seroma. The graft site was opened and irrigated with heparin solution and the seroma was evacuated. A surgical adhesive was applied to the graft due to sweating. The patient tolerated the procedure well and was discharged on hospital day two. Approximately two months post graft placement, the subject developed fever and chills with purulent drainage and tenderness along the graft site. An ultrasound was performed and demonstrated a weeping fluid collection along the graft site. The wound was closed with a surgical adhesive. The patient subsequently was started on iv antibiotics and was admitted to the hospital for infection of vascular access. The patient underwent incision and drainage of the right arm wound with placement of a wound vac. There was a good thrill and bruit in the graft , which was functioning and remained as the patient? S dialysis access. The patient was discharged in stable condition on hospital day eight. (b)(4). 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


[67371880] It was reported through the results of a clinical trial, that approximately two weeks post right upper arm av graft placement, the patient presented with a seroma with drainage at the graft site. The seroma was excised and the graft was repaired due to sweating. The patient tolerated the procedure well and was discharged on hospital day two. Approximately two months post graft placement, the patient developed symptoms of fever and chills with purulent drainage and tenderness along the graft site. The patient was started on antibiotics and was admitted to the hospital for infection and underwent incision and drainage of the wound with placement of a wound vacuum assisted closure. The patient was discharged in stable condition on hospital day eight.
Patient Sequence No: 1, Text Type: D, B5


[68984004] Manufacturing review: the device history records have been reviewed and 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 event reported to date for this lot number and failure mode. Visual/microscopic inspection: as the device was not returned, an inspection could not be performed. Functional/performance evaluation: as the device was not returned, an evaluation could not be performed. Image/photo review: as medical images and photos were not provided, a review could not be performed. Clinical trial review: an av graft was placed in the right upper arm as a study conduit for a clinical trial. Approximately two weeks post graft placement, the patient presented with a seroma and drainage from the graft at the antecubital fossa level. The patient was scheduled for repair of the graft and excision of the seroma. The graft site was opened and irrigated with heparin solution and the seroma was evacuated. A surgical adhesive was applied to the graft due to sweating. The patient tolerated the procedure well and was discharged on hospital day two. Approximately two months post graft placement, the subject developed fever and chills with purulent drainage and tenderness along the graft site. An ultrasound was performed and demonstrated a weeping fluid collection along the graft site. The wound was closed with a surgical adhesive. The patient subsequently was started on iv antibiotics and was admitted to the hospital for infection of vascular access. The patient underwent incision and drainage of the right arm wound with placement of a wound vac. There was a good thrill and bruit in the graft , which was functioning and remained as the patient? S dialysis access. The patient was discharged in stable condition on hospital day eight. Approximately six months post graft placement, the patient presented for hemodialysis and arteriovenous access was difficult to obtain. The patient was hospitalized and underwent angioplasty and stent placement. Under ultrasound guidance, access was gained towards the arterial end of the av graft and a 6 french sheath was placed into the right brachiocephalic artery. An angiogram was performed and demonstrated the main runoff was via the radial artery to the hand. There was a peri anastomotic high-grade stenosis of the brachial artery and 80% stenosis of the distal brachial artery which was completely separate from the av graft site. Angioplasty near the proximal brachial artery where the av graft had been anastomosed was performed with a 5 mm balloon. Angioplasty of the right distal brachial artery 10 cm separate from the av graft site was performed with a 4 mm x 8 cm balloon. Follow up imaging demonstrated no significant residual stenosis, although an injection of the av graft demonstrated a majority of the flow going out the graft and not down the hand. Therefore, a 6 french sheath was placed a few centimeters from the av graft access site. Circumferential control was obtained and a 7 mm x 2. 5 cm balloon expandable stent (other manufacturer) was placed. There was a palpable radial pulse and significantly more flow down the hand. The patient tolerated the procedure well and had significant improvement in the blood flow to the hand. The patient was discharged the next day with scheduled dialysis. Conclusion: the investigation can be confirmed for a leak at the graft. It can also be confirmed that the patient had an infection in the area of the graft however the relationship to the graft itself is unknown. Per the reported clinical trial results, the graft was flushed with heparin. Per ifu, "exposure to solutions may result in loss of graft's hydrophobic properties. Loss of the hydrophobic barrier may result in graft wall leakage. " therefore, the integrity of the graft could have been compromised. However, the definitive root cause is unknown. Labeling review: the current ifu (instructions for use) states: warnings: aggressive and/or excessive graft manipulation when tunneling, or placement within a too tight or too small tunnel, may lead to separation of the spiral beading and/or graft breakage. Avoid repeated or excessive clamping at the same location on the graft. If clamping is necessary, use only atraumatic or appropriate vascular smooth jawed clamps to avoid damage to the graft wall. Exposure to solutions (e. G. , alcohol, oil, aqueous solutions, etc. ) may result in loss of the graft? S hydrophobic properties. Loss of the hydrophobic barrier may result in graft wall leakage. Preclotting of this graft is unnecessary. Avoid excessive graft manipulation after exposure to blood or body fluids. Do not forcibly inject any solution through the lumen of the graft, or fill the graft with fluid prior to pulling it through the tunnel as loss of the graft? S hydrophobic properties may occur. Loss of the hydrophobic barrier may result in graft wall leakage. (b)(4). 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


[68984005] It was reported through the results of a clinical trial, that approximately two weeks post right upper arm av graft placement, the patient presented with a seroma with drainage at the graft site. The seroma was excised and the graft was repaired due to sweating. The patient tolerated the procedure well and was discharged on hospital day two. Approximately two months post graft placement, the patient developed symptoms of fever and chills with purulent drainage and tenderness along the graft site. The patient was started on antibiotics and was admitted to the hospital for infection and underwent incision and drainage of the wound with placement of a wound vacuum assisted closure. The patient was discharged in stable condition on hospital day eight.
Patient Sequence No: 1, Text Type: D, B5


[74193017] This event (2020394-2017-00067) was identified to be the same event as reported on mw 2020394-2016-00963. Manufacturing review: the device history records have been reviewed and 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 event reported to date for this lot number and failure mode. Visual/microscopic inspection: as the device was not returned, an inspection could not be performed. Functional/performance evaluation: as the device was not returned, an evaluation could not be performed. Image/photo review: as medical images and photos were not provided, a review could not be performed. Clinical trial review: an av graft was placed in the right upper arm as a study conduit for a clinical trial. Approximately two weeks post graft placement, the patient presented with a seroma and drainage from the graft at the antecubital fossa level. The patient was scheduled for repair of the graft and excision of the seroma. The graft site was opened and irrigated with heparin solution and the seroma was evacuated. A surgical adhesive was applied to the graft due to sweating. The patient tolerated the procedure well and was discharged on hospital day two. Approximately two months post graft placement, the subject developed fever and chills with purulent drainage and tenderness along the graft site. An ultrasound was performed and demonstrated a weeping fluid collection along the graft site. The wound was closed with a surgical adhesive. The patient subsequently was started on iv antibiotics and was admitted to the hospital for infection of vascular access. The patient underwent incision and drainage of the right arm wound with placement of a wound vac. There was a good thrill and bruit in the graft , which was functioning and remained as the patient? S dialysis access. The patient was discharged in stable condition on hospital day eight. Approximately six months post graft placement, the patient presented for hemodialysis and arteriovenous access was difficult to obtain. The patient was hospitalized and underwent angioplasty and stent placement. Under ultrasound guidance, access was gained towards the arterial end of the av graft and a 6 french sheath was placed into the right brachiocephalic artery. An angiogram was performed and demonstrated the main runoff was via the radial artery to the hand. There was a peri anastomotic high-grade stenosis of the brachial artery and 80% stenosis of the distal brachial artery which was completely separate from the av graft site. Angioplasty near the proximal brachial artery where the av graft had been anastomosed was performed with a 5 mm balloon. Angioplasty of the right distal brachial artery 10 cm separate from the av graft site was performed with a 4 mm x 8 cm balloon. Follow up imaging demonstrated no significant residual stenosis, although an injection of the av graft demonstrated a majority of the flow going out the graft and not down the hand. Therefore, a 6 french sheath was placed a few centimeters from the av graft access site. Circumferential control was obtained and a 7 mm x 2. 5 cm balloon expandable stent (other manufacturer) was placed. There was a palpable radial pulse and significantly more flow down the hand. The patient tolerated the procedure well and had significant improvement in the blood flow to the hand. The patient was discharged the next day with scheduled dialysis. Conclusion: the investigation can be confirmed for a leak at the graft. It can also be confirmed that the patient had an infection in the area of the graft however the relationship to the graft itself is unknown. Per the reported clinical trial results, the graft was flushed with heparin. Per ifu, "exposure to solutions may result in loss of graft's hydrophobic properties. Loss of the hydrophobic barrier may result in graft wall leakage. " therefore, the integrity of the graft could have been compromised. However, the definitive root cause is unknown. Labeling review: the current ifu (instructions for use) states: warnings: aggressive and/or excessive graft manipulation when tunneling, or placement within a too tight or too small tunnel, may lead to separation of the spiral beading and/or graft breakage. Avoid repeated or excessive clamping at the same location on the graft. If clamping is necessary, use only atraumatic or appropriate vascular smooth jawed clamps to avoid damage to the graft wall. Exposure to solutions (e. G. , alcohol, oil, aqueous solutions, etc. ) may result in loss of the graft? S hydrophobic properties. Loss of the hydrophobic barrier may result in graft wall leakage. Preclotting of this graft is unnecessary. Avoid excessive graft manipulation after exposure to blood or body fluids. Do not forcibly inject any solution through the lumen of the graft, or fill the graft with fluid prior to pulling it through the tunnel as loss of the graft? S hydrophobic properties may occur. Loss of the hydrophobic barrier may result in graft wall leakage. (b)(4). 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


[74193018] It was reported through the results of a clinical trial, that approximately two weeks post right upper arm av graft placement, the patient presented with a seroma with drainage at the graft site. The seroma was excised and the graft was repaired due to sweating. The patient tolerated the procedure well and was discharged on hospital day two. Approximately two months post graft placement, the patient developed symptoms of fever and chills with purulent drainage and tenderness along the graft site. The patient was started on antibiotics and was admitted to the hospital for infection and underwent incision and drainage of the wound with placement of a wound vacuum assisted closure. The patient was discharged in stable condition on hospital day eight.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2020394-2017-00067
MDR Report Key6329252
Report SourceHEALTH PROFESSIONAL,STUDY,USE
Date Received2017-02-14
Date of Report2017-08-16
Date of Event2016-09-01
Date Mfgr Received2017-07-17
Device Manufacturer Date2016-05-02
Date Added to Maude2017-02-14
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 FDA3
Event Location3
Manufacturer ContactJUDITH LUDWIG
Manufacturer Street1625 W 3RD ST.
Manufacturer CityTEMPE AZ 85281
Manufacturer CountryUS
Manufacturer Postal85281
Manufacturer Phone4803032689
Manufacturer G1BARD PERIPHERAL VASCULAR, INC.
Manufacturer Street1625 W 3RD ST.
Manufacturer CityTEMPE AZ 85281
Manufacturer CountryUS
Manufacturer Postal Code85281
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameIMPRA VASCULAR GRAFT
Generic NameEPTFE VASCULAR GRAFT
Product CodeDYF
Date Received2017-02-14
Catalog Number40S06
Lot NumberVTAR0657
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBARD PERIPHERAL VASCULAR, INC.
Manufacturer Address1625 W 3RD ST. TEMPE AZ 85281 US 85281


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2017-02-14

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