FDA Adverse Event Death Summary report: Y

EDWARDS COMMANDER DELIVERY SYSTEM

MDR report key: 11980100 · Received June 10, 2021

Report

Report Number
2015691-2021-03496
Event Type
Death
Date Received
June 10, 2021
Date of Event
January 1, 2021
Report Date
June 10, 2021
Manufacturer
EDWARDS LIFESCIENCES LLC
Product Code
NPU
PMA / PMN Number
P140031
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THIS REPORT PROVIDES DATA FROM (B)(6) REGISTRY DATA EXEMPTION NUMBER E2016006 AND SUMMARIZES 1 PERFORATION WITH OR W/O TAMPONADE EVENT FOR THE SAPIEN 3 VALVE IN THE MITRAL POSITION. THE TIME TO EVENT [TTE IN DAYS] FOR THIS EVENT WAS 0. THE DEVICE IDENTIFICATION (DI) NUMBERS FOR EDWARDS COMMANDER DELIVERY SYSTEM ARE: (B)(4). PER THE INSTRUCTIONS FOR USE, CARDIOVASCULAR INJURIES, INCLUDING PERFORATION OR DISSECTION OF VESSELS, VENTRICLE, MYOCARDIUM OR VALVULAR STRUCTURES, ARE POTENTIAL ADVERSE EVENTS ASSOCIATED WITH STANDARD CARDIAC CATHETERIZATION, BALLOON VALVULOPLASTY AND TRANSCATHETER HEART VALVE (THV) PROCEDURES. THERE ARE SEVERAL POTENTIAL ETIOLOGIES FOR CARDIAC PERFORATION DURING A THV PROCEDURE, INCLUDING PERFORATION BY THE GUIDEWIRE, THE DELIVERY SYSTEM, OR THE TRANSVENOUS PACER (TVP) LEAD. PHYSICIANS ARE EXTENSIVELY TRAINED BY EDWARDS BEFORE THEY ARE QUALIFIED TO USE TRANSCATHETER HEART VALVES. TRAINING INCLUDES PROPER GUIDEWIRE POSITIONING, FIXATION OF THE TVP TO PREVENT VENTRICLE PERFORATION, AND CAREFUL MANIPULATION OF DEVICES. IN THIS CASE, SPECIFIC PROCEDURAL DETAILS ARE NOT AVAILABLE TO DETERMINE POTENTIAL CONTRIBUTING FACTORS TO THE EVENT. THE IFU AND TRAINING MANUALS HAVE BEEN REVIEWED AND NO INADEQUACIES HAVE BEEN IDENTIFIED WITH REGARDS TO WARNINGS, CONTRAINDICATIONS, AND THE DIRECTIONS/CONDITIONS FOR THE SUCCESSFUL USE OF THE DEVICE. COMPLAINT HISTORIES FOR ALL REPORTED EVENTS ARE REVIEWED AGAINST TRENDING CONTROL LIMITS ON A MONTHLY BASIS, AND ANY EXCURSIONS ABOVE THE CONTROL LIMITS ARE ASSESSED AND DOCUMENTED AS PART OF THIS MONTHLY REVIEW. NO CORRECTIVE OR PREVENTATIVE ACTIONS ARE REQUIRED. SUMMARY REPORTING.

Description of Event or Problem · 1

(B)(6) REGISTRY SUMMARY REPORTING FOR ADVERSE EVENT SUBMISSION FOR Q1 2021 DATA EXTRACT FOR MITRAL DEATH FOR THE SAPIEN 3 VALVE. THIS REPORT SUMMARIZES 1 PERFORATION WITH OR W/O TAMPONADE EVENT FOR THE SAPIEN 3 VALVE. THE PATIENT AGE IS (B)(6). THE BREAKDOWN FOR GENDER IS 1 FEMALE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
872712 EDWARDS COMMANDER DELIVERY SYSTEM PROSTHESIS, MITRAL VALVE, PERCUTANEOUSLY DELIVERED NPU EDWARDS LIFESCIENCES LLC COMMANDER DELIVERY SYSTEM UNKNOWN N/A

Patients

Seq Age Sex Outcome Treatment
1 71 YR Death