MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-01-15 for CROSSER CTO RECANALIZATION CATHETERS CRUS6A manufactured by Bard Peripheral Vascular, Inc..
[179312732]
For the reported event, the devices was not returned to bd. An x-ray image was provided and reviewed. Particular failure mode was confirmed for the device. However, the investigation is inconclusive for the difficulty to advance. A root cause has not been determined. The device was labeled for single use.
Patient Sequence No: 1, Text Type: N, H10
[179312733]
This report summarizes one malfunction. A review of the reported information indicated that model crus6a. Recanalization catheter allegedly experienced detachment of device or device component and difficult to advance. This report was received from a single source. This event did involve patient with no reported patient injury. The patient is (b)(6) years of age, the gender is male, and the weight is (b)(6) lbs.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2020394-2020-00301 |
| MDR Report Key | 9591786 |
| Date Received | 2020-01-15 |
| Date of Report | 2020-01-15 |
| Date Mfgr Received | 2019-12-31 |
| Date Added to Maude | 2020-01-15 |
| 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 | 1415 W. 3RD STREET |
| 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 | CROSSER CTO RECANALIZATION CATHETERS |
| Generic Name | RECANALIZATION CATHETER |
| Product Code | PDU |
| Date Received | 2020-01-15 |
| Model Number | CRUS6A |
| Catalog Number | CRUS6A |
| Lot Number | GFDS0804 |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| 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 | 2020-01-15 |