FDA Adverse Event Injury Summary report: N

ATRICURE BIPOLAR SYSTEM

MDR report key: 11894870 · Received May 27, 2021

Report

Report Number
3011706110-2021-00026
Event Type
Injury
Date Received
May 27, 2021
Report Date
May 27, 2021
Manufacturer
ATRICURE, INC.
Product Code
OCL
PMA / PMN Number
K110117
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
EZ
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE DEVICE WAS NOT RETURNED FOR EVALUATION AND A DEVICE HISTORY REVIEW WAS UNABLE TO BE COMPLETED AS THE RELEVANT LOT NUMBER FOR THE EMR2 DEVICE WAS NOT REPORTED OR ABLE TO BE SUBSEQUENTLY ASCERTAINED.

Description of Event or Problem · 1

DURING A LITERATURE SEARCH, ATRICURE DETERMINED THAT TWO PATIENTS TREATED BETWEEN 2012 AND 2015 HAD ADVERSE EVENTS, WHICH MAY HAVE BEEN CAUSED BY OR CONTRIBUTED TO BY THE EMR2 DEVICE. THE LITERATURE REPORTED TWO CASES WHERE BLEEDING REQUIRED CONVERSION OF THE PROCEDURE THROUGH A STERNOTOMY. THE PATIENT FULLY RECOVERED. ATRICURE REVIEWED OTHER COMPLICATIONS LISTED WITHIN THE PAPER, BUT WERE UNABLE TO FIND A CAUSE OR CONTRIBUTION TO AN ATRICURE DEVICE. THIS ADVERSE EVENT IS THE RESULT OF A PROCEDURAL COMPLICATION. NO DEVICE MALFUNCTION WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
792981 ATRICURE BIPOLAR SYSTEM ATRICURE BIPOLAR SYSTEM OCL ATRICURE, INC. EMR2 UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Life Threatening| R