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 2020-03-31 for STERLING 24716 manufactured by Boston Scientific Corporation.
[185935339]
It was reported that the balloon had a hole. The 90-95% stenosed, target lesion was located in the highly calcified anterior tibial artery. A 3. 0x220x150 sterling catheter was advance for dilation. However, during inflation at nominal pressure, the balloon was observed to not hold pressure. The balloon was taken out and inflated outside the body, where the physician noticed a hole. Atherectomy was performed with 2. 0mm rotablator. The procedure was completed with a different device. There were no patient complications nor injuries reported.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2134265-2020-04154 |
| MDR Report Key | 9903723 |
| Report Source | COMPANY REPRESENTATIVE,HEALTH |
| Date Received | 2020-03-31 |
| Date of Report | 2020-03-31 |
| Date of Event | 2020-03-24 |
| Date Mfgr Received | 2020-03-25 |
| Device Manufacturer Date | 2020-01-14 |
| Date Added to Maude | 2020-03-31 |
| 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 | TWO SCIMED PLACE |
| Manufacturer City | MAPLE GROVE MN 55311 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 55311 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | STERLING |
| Generic Name | CATHETER, PERCUTANEOUS |
| Product Code | LIT |
| Date Received | 2020-03-31 |
| Model Number | 24716 |
| Catalog Number | 24716 |
| Lot Number | 0025036246 |
| 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 | 2020-03-31 |