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Hogan D, Otoya D, Lavingia K, Amendola M. What is the MAUDE Database Telling us about 510(k) Authorization? Evaluation of Two Generations of Endovascular Arteriovenous Fistula Devices. Ann Vasc Surg 2024; 106:394-399. [PMID: 38815918 DOI: 10.1016/j.avsg.2024.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND In 2019, Bard Peripheral Vascular Inc (BV; now Becton, Dickinson and Company; Sparks, Maryland) received Food and Drug Administration (FDA) approval to begin marketing the WavelinQ EndoAVF System through a process known as 510(k) authorization. Such authorization relies on BV proving that the new WavelinQ EndoAVF System was of "substantial equivalence" to the WavelinQ 4F EndoAVF System. We set forth to analyze patient problems and device issues reported for the new device and determine if they were significantly different from the predicate device its 510(k) approval was based on. METHODS FDA database Manufacturer and User Facility Device Experience was queried for all adverse report events for the WavelinQ EndoAVF System and WavelinQ 4F EndoAVF System. Data were collected on patient issues and device issues. Fisher's exact test was used. RESULTS There were a total of 125 reports for the WavelinQ 4F EndoAVF System and 78 for the WavelinQ EndoAVF System. There was a significant increase in patient problem "hypertension" (0% vs. 5.1%; P = 0.02) for the WavelinQ EndoAVF System but a statistically significant decrease in device issue "failure to align" for the WavelinQ EndoAVF System (24.8% vs. 10.3%; P ≤ 0.01). CONCLUSIONS There were changes in device and patient outcomes between the WavelinQ EndoAVF System and WavelinQ 4F EndoAVF System. While we noted a decrease in device problem "failure to align", there was an overall increase in patients' "hypertension" rates. This highlights the importance of the FDA Manufacturer and User Facility Device Experience reporting in ensuring that device safety is maintained when devices are approved for marketing through the 510(k) process.
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Affiliation(s)
- Douglas Hogan
- Division of Vascular and Endovascular Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA
| | - Diana Otoya
- Division of Vascular and Endovascular Surgery, Virginia Commonwealth University Health System, Richmond, VA; Division of Vascular and Endovascular Surgery, Central Virginia VA Healthcare System, Richmond, VA
| | - Kedar Lavingia
- Division of Vascular and Endovascular Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA; Division of Vascular and Endovascular Surgery, Central Virginia VA Healthcare System, Richmond, VA.
| | - Michael Amendola
- Division of Vascular and Endovascular Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA; Division of Vascular and Endovascular Surgery, Central Virginia VA Healthcare System, Richmond, VA
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Li X, Feng Y, Gong Y, Chen Y. Assessing the Reproducibility of Research Based on the Food and Drug Administration Manufacturer and User Facility Device Experience Data. J Patient Saf 2024:01209203-990000000-00205. [PMID: 38470959 DOI: 10.1097/pts.0000000000001220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
OBJECTIVE This article aims to assess the reproducibility of Manufacturer and User Facility Device Experience (MAUDE) data-driven studies by analyzing the data queries used in their research processes. METHODS Studies using MAUDE data were sourced from PubMed by searching for "MAUDE" or "Manufacturer and User Facility Device Experience" in titles or abstracts. We manually chose articles with executable queries. The reproducibility of each query was assessed by replicating it in the MAUDE Application Programming Interface. The reproducibility of a query is determined by a reproducibility coefficient that ranges from 0.95 to 1.05. This coefficient is calculated by comparing the number of medical device reports (MDRs) returned by the reproduced queries to the number of reported MDRs in the original studies. We also computed the reproducibility ratio, which is the fraction of reproducible queries in subgroups divided by the query complexity, the device category, and the presence of a data processing flow. RESULTS As of August 8, 2022, we identified 523 articles from which 336 contained queries, and 60 of these were executable. Among these, 14 queries were reproducible. Queries using a single field like product code, product class, or brand name showed higher reproducibility (50%, 33.3%, 31.3%) compared with other fields (8.3%, P = 0.037). Single-category device queries exhibited a higher reproducibility ratio than multicategory ones, but without statistical significance (27.1% versus 8.3%, P = 0.321). Studies including a data processing flow had a higher reproducibility ratio than those without, although this difference was not statistically significant (42.9% versus 17.4%, P = 0.107). CONCLUSIONS Our findings indicate that the reproducibility of queries in MAUDE data-driven studies is limited. Enhancing this requires the development of more effective MAUDE data query strategies and improved application programming interfaces.
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Affiliation(s)
- Xinyu Li
- From the Department of Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Yubo Feng
- From the Department of Computer Science, Vanderbilt University, Nashville, Tennessee
| | - Yang Gong
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, Texas
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Healy GM, Ahrari A, Alkhalifah F, Oreopoulos G, Tan KT, Jaberi A, Mafeld S. Typology, Severity, and Outcomes of Adverse Events Related to Angiographic Equipment-A Ten-Year Analysis of the FDA MAUDE Database. Can Assoc Radiol J 2023; 74:737-744. [PMID: 37023704 DOI: 10.1177/08465371231167990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Purpose: Angiographic equipment is a key component of healthcare infrastructure, used for endovascular procedures throughout the body. The literature on adverse events related to this technology is limited. The purpose of this study was to analyze adverse events related to angiographic devices from the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database. Methods: MAUDE data on angiographic imaging equipment from July 2011 to July 2021 were extracted. Qualitative content analysis was performed, a typology of adverse events was derived, and this was used to classify the data. Outcomes were assessed using the Healthcare Performance Improvement (HPI) and Society of Interventional Radiology (SIR) adverse event classifications. Results: There were 651 adverse events reported. Most were near misses (67%), followed by precursor safety events (20.5%), serious safety events (11.2%), and unclassifiable (1.2%). Events impacted patients (42.1%), staff (3.2%), both (1.2%), or neither (53.5%). The most common events associated with patient harm were intra-procedure system shut down, foot pedal malfunction, table movement malfunction, image quality deterioration, patient falls, and fluid damage to system. Overall, 34 (5.2%) events were associated with patient death; 18 during the procedure and 5 during patient transport to another angiographic suite/hospital due to critical failure of equipment. Conclusion: Adverse events related to angiographic equipment are rare; however, serious adverse events and deaths have been reported. This study has defined a typology of the most common adverse events associated with patient and staff harm. Increased understanding of these failures may lead to improved product design, user training, and departmental contingency planning.
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Affiliation(s)
- Gerard M Healy
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
- Department of Radiology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Ireland
| | - Aida Ahrari
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
| | - Fahd Alkhalifah
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
| | - George Oreopoulos
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
- Division of Vascular Surgery, University Health Network, University of Toronto, Toronto, ON, CA
| | - Kong Teng Tan
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
| | - Arash Jaberi
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
| | - Sebastian Mafeld
- Division of Vascular and Interventional Radiology, Joint Department of Medical Imaging, University Health Networkand Sinai Health System, Toronto, ON, CA
- Department of Medical Imaging, University of Toronto, Toronto, ON, CA
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Beck AW, Haulon S, Ouriel K. Not So Fast, All Devices and Their Materials Are Different. Eur J Vasc Endovasc Surg 2023; 65:611-612. [PMID: 36796672 DOI: 10.1016/j.ejvs.2023.01.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/26/2023] [Indexed: 02/16/2023]
Affiliation(s)
| | - Stéphan Haulon
- Groupe Hospitalier Saint Joseph, Paris Saclay University, Paris, France
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