MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,distri report with the FDA on 2020-02-20 for OPTICROSS HD 8668 manufactured by Boston Scientific Corporation.
[180216854]
It was reported that catheter stuck in stent occurred. The 90% stenosed, 23mm in length, 3. 5mm vessel diameter, target lesion was located in the moderately tortuous and mildly calcified left main trunk and left anterior descending artery. An opticross hd imaging catheter was advanced for use. During kissing balloon technique, the opticross seemed to be stuck in the previously implanted non-bsc stent. A 0. 018 guidewire was inserted and successfully released the device. The procedure was completed with another of the same device. There were no patient complications reported and the patient condition is good.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2134265-2020-01313 |
| MDR Report Key | 9734196 |
| Report Source | COMPANY REPRESENTATIVE,DISTRI |
| Date Received | 2020-02-20 |
| Date of Report | 2020-02-20 |
| Date of Event | 2020-01-29 |
| Date Mfgr Received | 2020-01-30 |
| Device Manufacturer Date | 2019-11-30 |
| Date Added to Maude | 2020-02-20 |
| 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 | JAY JOHNSON |
| Manufacturer Street | TWO SCIMED PLACE |
| Manufacturer City | MAPLE GROVE MN 55311 |
| Manufacturer Country | US |
| Manufacturer Postal | 55311 |
| Manufacturer Phone | 7634942574 |
| Manufacturer G1 | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Street | 2546 CALLE PRIMERA |
| Manufacturer City | ALAJUELA |
| Manufacturer Country | CS |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | OPTICROSS HD |
| Generic Name | CATHETER, ULTRASOUND, INTRAVASCULAR |
| Product Code | OBJ |
| Date Received | 2020-02-20 |
| Model Number | 8668 |
| Catalog Number | 8668 |
| Lot Number | 0024851038 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | BOSTON SCIENTIFIC CORPORATION |
| Manufacturer Address | TWO SCIMED PLACE MAPLE GROVE MN 55311 US 55311 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-02-20 |