FDA Adverse Event Malfunction Summary report: N

NAVISTAR THERMO-COOL DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER

MDR report key: 1051320 · Received May 23, 2008

Report

Report Number
9673241-2008-00022
Event Type
Malfunction
Date Received
May 23, 2008
Date of Event
April 29, 2008
Report Date
April 29, 2008
Manufacturer
BIOSENSE WEBSTER, INC. (JUAREZ)
Product Code
OAD
PMA / PMN Number
P030031
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

PRODUCT EVAL IS IN PROGRESS. THIS REPORT WILL BE UPDATED UPON COMPLETION OF PRODUCT EVAL.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE TIP WAS SEPARATED FROM THE SHAFT OF THE THERMOCOOL CATHETER. THE PROBLEM WAS DISCOVERED BEFORE USE ON PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NAVISTAR THERMO-COOL DIAGNOSTIC/ABLATION DEFLECTABLE TIP CATHETER CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL OAD BIOSENSE WEBSTER, INC. (JUAREZ) D-1197-18-S 13359067

Patients

Seq Age Sex Outcome Treatment
1