MAUDE MDR 9700386

MDR report key
9700386
Report number
2126666-2020-00009
Event key
0
Event type
3
Date of event
2020-01-22
Date received
2020-02-12
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
SHARON SEIFERT
Address
340 LAKE HAZELTINE DRIVE CHASKA, MN US
Phone
641-641-6418
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1THRUWAY GUIDEWIREWIRE, GUIDE, CATHETERLAKE REGION MEDICALDQXY R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12020-02-120

Event Narratives#

N

Patient 1

THE DEVICE WAS NOT RECEIVED FOR EVALUATION; THEREFORE NO PHYSICAL ANALYSIS OF THE DEVICE CAN BE PERFORMED. THE LOT NUMBER IS UNKNOWN; THEREFORE THE MANUFACTURING BATCH RECORDS FOR THE COMPLAINT DEVICE CANNOT BE REVIEWED. AT THIS TIME IT IS NOT POSSIBLE TO ASSIGN A DEFINITIVE ROOT CAUSE FOR THE EVENT AS REPORTED. AS NOTED IN THE PRECAUTIONS WITHIN THE DEVICE INSTRUCTIONS FOR USE, "FREE MOVEMENT OF THE GUIDEWIRE WITHIN A CATHETER IS AN IMPORTANT FEATURE OF THE STEERABLE GUIDEWIRE SYSTEM BECAUSE IT GIVES THE USER VALUABLE TACTILE INFORMATION. TEST THE SYSTEM FOR ANY RESISTANCE PRIOR TO USE." BASED ON THE INFORMATION PROVIDED TO DATE, CLINICAL AND/OR PROCEDURAL FACTORS APPEAR TO HAVE IMPACTED ON THE EVENT AS REPORTED. PATIENT AGE WAS REPORTED TO BE OVER 18 YEARS. IF THERE IS ANY FURTHER RELEVANT INFORMATION PROVIDED, A FOLLOW UP MEDWATCH REPORT WILL BE FILED.

D

Patient 1

EVENT DESCRIPTION: PER EMAIL, IT WAS REPORTED THAT: AFTER DOING TWO PASSES WITH THE BLADES OFF. THEY HAD THE BLADES OFF THEN THEY WERE UNABLE TO RETRACT DUE TO THE WIRE SPINNING WITHIN THE CATHETER. THIS HAPPEN DURING THE CASE. THEY HAD TO PULL THE ENTIRE DEVICE OUT AND THEY DON'T HAVE TO PUT IN ONE IN. NO COMPLICATION AND PATIENT IS FINE. (B)(6) 2020: AS PER ADDITIONAL INFORMATION RECEIVED: WHEN ATTEMPTING TO REX THE JETSTREAM CATHETER OUT, THE DEVICE BECAME STUCK ONTO THE THRUWAY WIRE AND WE WERE UNABLE TO REX OUT. THE WIRE AND JETSTREAM WERE REMOVED TOGETHER AS ONE UNIT.