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Executive Summary

BD's PowerGlide Pro has the highest injury rate of any BD vascular access product -- 77% of reported events result in patient injury (n=26). The failure pattern is consistent: mechanical breakage during insertion, with 90% of extracted failures classified as mechanical (n=90). Stiletto's guidewire-free design eliminates the insertion mechanism responsible for these failures.

This report uses FDA MAUDE data to analyze BD's competitive vulnerability and position Stiletto as the safety-first alternative. The data is real, the limitations are stated clearly, and every claim includes its sample size.


What the Data Shows

FindingValueSample SizeConfidence
PowerGlide Pro injury rate77%n=26 eventsHigh -- rate is rate regardless of volume
BD Power line mechanical failures90%n=90 extracted eventsModerate -- 30% extraction coverage
User error blamed = justified39% eachn=38 extracted eventsLow -- small sample, needs more extraction
Stiletto design advantageEliminates guidewire mechanismEngineering analysisHigh -- no wire = no wire failure
Market size (extended dwell midline)$1.3-3.2B globallyIndustry reportsModerate -- range reflects methodology differences
BD vascular access share~40%Industry estimatesModerate

What the Data Doesn't Show

  • Absolute safety comparison -- BD has ~40% market share; Stiletto has <5%. More devices in field = more events reported. Raw event counts are not comparable.
  • Real complication rates -- MAUDE captures 1-10% of actual events. We see patterns, not prevalence.
  • Stiletto failure modes -- With <5% market share and limited time on market, absence of events is expected, not proof of perfection.
  • Precise market share -- No public source gives exact midline market share by manufacturer.

The Competitive Opportunity

BD dominates on distribution, GPO contracts, and sales force. They are vulnerable on safety data. The argument is not "BD has more events than Stiletto" (that's market share). The argument is:

  1. BD's own data shows a pattern -- 77% injury rate on PowerGlide Pro, consistent mechanical failures
  2. The failure mechanism is structural -- guidewire interaction with catheter at the needle bevel
  3. Stiletto removes the mechanism -- guidewire-free design eliminates the failure mode entirely
  4. The design advantage is permanent -- not a manufacturing fix, but a different engineering approach

Report Contents

SectionWhat You'll Learn
The DeviceWhat Stiletto is, how SlipStream works, why guidewire-free matters
The MarketMarket size, buyer personas, top procedure markets
Competitive LandscapeBD injury rates, failure modes, what MAUDE can and can't tell you
Selling the StorySPIN framework, battle cards, and what NOT to claim
Go-to-MarketTarget accounts, channels, AI outreach, ScanPath in sales
MethodologyData quality assessment, API usage, limitations, reproducible queries

Data: FDA MAUDE (2.48M events, 1992-2026). CMS Medicare 2022 procedure volumes. Analysis current as of February 2026. All claims include sample sizes -- see Methodology for data quality details.