FDA Adverse Event Injury Summary report: N

NAVISTAR/CELSIUS THERMO-COOL DIAGNOSTIC/ABLATION DEFLECTABLE

MDR report key: 1192803 · Received October 8, 2008

Report

Report Number
9673241-2008-00040
Event Type
Injury
Date Received
October 8, 2008
Date of Event
September 11, 2008
Report Date
September 15, 2008
Manufacturer
BIOSENSE WEBSTER, INC. (JUAREZ)
Product Code
OAD
PMA / PMN Number
P030031
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SP
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE INSTRUCTION FOR USE CONTRAINDICATES USE OF THE CATHETER IN PATIENT WITH PROSTHETIC VALVE.

Description of Event or Problem · 1

EVENT OCCURRED DURING AN ISCHEMIC VENTRICULAR TACHYCARDIA PROCEDURE. RETROGRADE AORTIC ACCESS WITH AN IRRIGATED TIP CATHETER. PATIENT HAD A METALLIC MITRAL BIVALVE. LEFT VENTRICULE WAS BEING MAPPED WHEN, UNINTENTIONALLY, THE CATHETER GOT TRAPPED INSIDE THE VALVE. IT IS WORTHWHILE NOTING THAT THE LEFT ATRIUM MAPPING WAS NOT THE TARGET OF THE PROCEDURE (IN FACT, WHEN THE INCIDENCE TOOK PLACE, THE AIM WAS TO PERFORM THE LEFT VENTRICLE MAPPING). ATTEMPT TO REMOVE THE CATHETER WAS NOT SUCCESSFUL. THEREFORE THE CATHETER HAD TO BE REMOVED SURGICALLY. THE PATIENT WAS STABLE AND RECOVERING FROM THE SURGERY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 NAVISTAR/CELSIUS THERMO-COOL DIAGNOSTIC/ABLATION DEFLECTABLE CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF A OAD BIOSENSE WEBSTER, INC. (JUAREZ) D-1197-17-S 13349765

Patients

Seq Age Sex Outcome Treatment
1 49 YR Hospitalization| L| R