MAUDE MDR 8422459

MDR report key
8422459
Report number
1220948-2019-00025
Event key
0
Event type
3
Date of event
2019-02-08
Date received
2019-03-14
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
2
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. PRAGYA THIKEY
Address
63 SECOND AVE BURLINGTON MA 01803 US
Phone
781-781-7812
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1HYDRO EXPANDABLE LEMAITRE VALVULOTOMEVALVULOTOMELEMAITRE VASCULAR, INC.MGZ1009-00ELVH1464VY R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12019-03-1401. O

Event Narratives#

N

Patient 1

WE HAVE RECEIVED THE DEVICE FOR EVALUATION AND WE HAVE CONFIRMED THE REPORTED INCIDENT. WE OBSERVED THAT ONE OF THE BLADES WAS PROTRUDING OUT OF THE RETAINER IN ITS CLOSED CONFIGURATION. THE CENTERING HOOP OF THIS SAME BLADE WAS ALSO FOUND BENT. OUR LOT HISTORY RECORDS REVIEW FOR THIS LOT NUMBER 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. IT IS POSSIBLE THAT THE BLADE WAS DAMAGED DURING PACKAGING OR DURING SHIPPING THE DEVICE TO THE HOSPITAL. IT IS ALSO POSSIBLE THAT THIS DEVICE WAS HANDLED AGGRESSIVELY AT THE USER FACILITY DURING PRE-USE CHECK THAT COULD HAVE LED TO THIS DEFECT. DURING OUR EVALUATION, WE ALSO OBSERVED A HEAVY KINK AT THE MIDDLE OF THIS DEVICE ALTHOUGH THIS DEVICE WAS REPORTED TO BE NOT USED IN A PATIENT. WHILE WE ARE INCONCLUSIVE ABOUT THE EXACT ROOT CAUSE OF THE DEFECT IN THIS DEVICE, WE HAVE IMPLEMENTED A CORRECTIVE AND PREVENTIVE ACTION (CAPA) TO RESOLVE THIS TYPE OF ISSUE. IN THE CAPA, WE HAVE MADE A SERIES OF IMPROVEMENTS AND REPLACEMENTS TO OUR MANUFACTURING FIXTURES TO RESOLVE THIS ISSUE. THE CORRECTIVE ACTIONS THAT WE HAVE IMPLEMENTED HAVE REDUCED THE RATE OF FAILURE WITH THIS DEVICE FOR THIS ISSUE. 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. DEVICE WAS NOT USED IN THE PATIENT. ANOTHER VALVULOTOME WAS USED FOR THE SURGERY.

D

Patient 1

DURING PRE-USE CHECK, SURGEON NOTICED ONE OF THE BLADES DID NOT CLOSE PROPERLY INTO ITS HOUSING. THE CENTERING HOOP OF THIS SAME BLADE WAS ALSO FOUND BENT.