Events

Recall of PeriVac

According to U.S. Food and Drug Administration, this recall involved a device in United States that was produced by Boston Scientific.

What is this?

A correction or removal action taken by a manufacturer to address a problem with a medical device. Recalls occur when a medical device is defective, when it could be a risk to health, or when it is both defective and a risk to health.

Learn more about the data here
  • Type of Event
    Recall
  • Event ID
    27454
  • Event Risk Class
    Class 2
  • Event Number
    Z-0071-04
  • Event Date Posted
    2003-10-30
  • Event Status
    Terminated
  • Event Country
    United States
  • Event Terminated Date
    2004-03-09
  • Event Source
    USFDA
  • Event Source URL
    https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfres/res.cfm?id=29903
  • Notes / Alerts
    U.S. data is current through June 2018. All of the data comes from the U.S. Food and Drug Administration, except for the category Manufacturer Parent Company.
    The Parent Company was added by ICIJ.
    The parent company information is based on 2017 public records.
  • Extra notes in the data
    Wire, Guide, Catheter - Product Code DQX
  • Reason
    The product has the potential to break during withdrawal process.
  • Action
    On 9/22/03, the firm issued letters via Federal Express to all its direct consignees, informing them of the affected devices and providing instructions on the recall.

Device

PeriVac
  • Model / Serial
    Batch numbers: All units of this models; UPN numbers: M00443041, M00443051, M00443040, M00443050
  • Product Classification
    Cardiovascular Devices
  • Device Class
    2
  • Implanted device?
    No
  • Distribution
    The product was distributed worldwide to hospitals and medical supply distributors, totaling 1100 consignees. The recall was appropriately extended to the consumer/user level; i.e., the wholesalers/distributors, and hospitals which received the recalled product. The product was distributed by direct sale to the following government/military accounts: 1) Brooke Army Med Ctr., 3851 Roger Brook Dr., Fort Sam Houston, TX 78234, 210-916-3083; 2) National Naval Med Ctr., 8901 Wisconsin Ave., Bethesda, MD 20889, 301-295-6756; 3) Naval Med Center, 34800 Bob Wilson Dr. San Diego, CA 92134, 619-532-9570; 4) VA Med Center, 4500 S Lancaster Rd., Dallas, TX 75216, 214-857-1757; 5) VA Med Center, 385 Tremont Ave., East Orange, NJ 07018, 973-676-1241; 6) VA Med Center, 50 Irving St., NW, Washington, DC 20422, 202-745-8000; 7) VA Med Center, BLDG 143 ? 1970 Roanoke Blvd. Salem, VA 24153, 540-983-1051; 8) VA Med Center, 3600 30th St., BLDG ? 10, Des Moines, IA 50310, 516-266-6062; 9) VA Med Center, Highway 6th West, Iowa City, IA 52246, 319-338-0581; 10) VA Med Center, 1601 Perdido St., New Orleans, LA 70146, 504-589-5994; 11) VA Med Center, 2002 Holconbe Blvd, Houston, TX 77030, 713-791-1414; 12) VA Med Center, 1055 Clermont St., Denver, CO 80220, 303-393-2850; 13) VA Med Center, 500 Foothill Dr. Salt Lake City, UT 84148, 801-584-1243; 14) VA Med Center, 1501 San Pedro SE, albuquerque, NW 87108, 505-256-2727; 15) VA Med Center, 3350 La Jolla Village Dr. San Diego, CA 92161, 858-552-8585; 16) VA Med Center, 3801Miranda Ave., Palo Alto, CA 94304, 650-447-2560; 17) VA Med Center, 1660 S Columbian Way, Seattle, WA 98108, 206-764-2008 18) VA Med Center, 130 W Kingsbridge Rd., Bronx, NY 10468, 718-584-9000; 19) VA Med Center, 5901 E 7th St., Bld 149, Long Beach, CA 90822, 310-547-8220; 20) VA Med Center, 10535 Hospital Way, Mather, CA 95655, 916-643-5844; 21)VA Westside Medical Center, 350 E Erie St., Chico, IL 60611, 312-943-6600
  • Product Description
    PeriVac¿ brand Pericardial Fluid Aspiration Procedure Kit (Pericardiocentensis Kit), with Pigtail Drainage Catheter; Model/Catalog Numbers: 4304 and 4305
  • Manufacturer
    Boston Scientific

Manufacturer

Boston Scientific
  • Manufacturer Address
    Boston Scientific, 2710 Orchard Pkwy, San Jose CA 95134
  • Source
    USFDA