HYDRO LEMAITRE VALVULOTOME 1009-00

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-04-27 for HYDRO LEMAITRE VALVULOTOME 1009-00 manufactured by Lemaitre Vascular, Inc..

Event Text Entries

[106970634] We have received and evaluated one of the two complaint devices ( lot# elvh1367v) since the other unit was discarded by the hospital. Please refer to manufacturer's report number 1220948-2018-00025 for another report. We were able to confirm the reported incident. We found that one of the blades did not insert into the retainer when the centering hoops were closed. Once this blade was manually fixed, all of the blades entered and exited the housing/retainer properly upon closure of the hoops. We opened and closed the blades multiple times. All of the blades closed properly. Our lot history records review for lot number elvh1367v did not reveal any discrepancies related to the complaint event either in the manufacturing or packaging processes. Please note that we do conduct 100% inspection of the blade assembly during the manufacturing process. Our quality group also samples these devices before final packaging to ensure proper blade adjustment. However, it is possible that one of the blades was not well aligned during the manufacturing process. The blade alignment process includes manual adjustment of each blade by the operator. Operator errors, though rare, are possible due to the manual nature of the adjustments. While we are inconclusive about the exact root cause of this defect, we have previously implemented a corrective and preventive action (capa) to resolve this type of issue. In the capa we made a series of improvements and replacements to our manufacturing fixtures to resolve this issue. The device in this report represents the first complaint of this type since implementation of the corrective actions. The complaint rate since implementation is currently (b)(4) units ((b)(4)%). We have not received any other complaints related to this issue on devices manufactured after completion of the corrective actions. The current reported rate of occurrence for this defect is (b)(4)%, which is within our expected rate of occurrence and is in line with our risk documentation. We believe that the corrective actions we have implemented have adequately reduced the rate of occurrence. Our ifu clearly informs users to inspect the blades for damage and alignment prior to use. In this case, the user properly followed the risk mitigation measures (ifu) and properly identified the issue.
Patient Sequence No: 1, Text Type: N, H10


[106970635] Before the procedure, the surgeon tested the blades functionality of the valvulotome. The blades opened properly but the surgeon was unable to close one of the blades into its housing. So, he opened the second device but found the same issue with this device as well. The lot number of the first device could not be determined. The lot number of the second device is elvh1367v. Based on the description, this is report 1 of 2.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1220948-2018-00024
MDR Report Key7469555
Date Received2018-04-27
Date of Report2018-04-27
Date of Event2018-03-26
Date Mfgr Received2018-03-28
Device Manufacturer Date2017-11-22
Date Added to Maude2018-04-27
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 ContactMR. PRAGYA THIKEY
Manufacturer Street63 SECOND AVE
Manufacturer CityBURLINGTON MA 01803
Manufacturer CountryUS
Manufacturer Postal01803
Manufacturer Phone7812212266
Manufacturer G1LEMAITRE VASCULAR, INC.
Manufacturer Street63 SECOND AVE
Manufacturer CityBURLINGTON MA 01803
Manufacturer CountryUS
Manufacturer Postal Code01803
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameHYDRO LEMAITRE VALVULOTOME
Generic NameVALVULOTOME
Product CodeMGZ
Date Received2018-04-27
Returned To Mfg2018-04-23
Catalog Number1009-00
Lot NumberELVH1367V
OperatorPHYSICIAN
Device AvailabilityR
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerLEMAITRE VASCULAR, INC.
Manufacturer Address63 SECOND AVE BURLINGTON MA 01803 US 01803


Patients

Patient NumberTreatmentOutcomeDate
10 2018-04-27

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