MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2018-11-29 for TRUE FLOW DILATATION CATHETER TF0203511 manufactured by Bard Peripheral Vascular, Inc..
[128877527]
No medical records and no medical images were provided to the manufacturer. The lot number for the device was provided. The device history records are currently under review. The device was returned to the manufacturer for evaluation. The investigation of the reported event is currently underway.
Patient Sequence No: 1, Text Type: N, H10
[128877528]
It was reported that during preparation for a valvuloplasty procedure, the balloon valvuloplasty catheter allegedly would not thread onto the guidewire. It was further reported that the balloon valvuloplasty catheter was exchanged over the guidewire for another and the procedure was successfully performed. There was no patient contact.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2020394-2018-02140 |
| MDR Report Key | 8118554 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2018-11-29 |
| Date of Report | 2019-01-15 |
| Date of Event | 2016-10-27 |
| Date Mfgr Received | 2018-12-20 |
| Date Added to Maude | 2018-11-29 |
| 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 | C.R. BARD, INC. (GFO) |
| Manufacturer Street | 289 BAY ROAD |
| Manufacturer City | QUEENSBURY NY 12804 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 12804 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | TRUE FLOW DILATATION CATHETER |
| Generic Name | BALLOON VALVULOPLASTY CATHETER |
| Product Code | OZT |
| Date Received | 2018-11-29 |
| Returned To Mfg | 2016-11-07 |
| Catalog Number | TF0203511 |
| Lot Number | GFAU0053 |
| Device Expiration Date | 2017-06-28 |
| 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 | 2018-11-29 |