FDA Adverse Event Injury Summary report: N

LEAD EXTRACTION EVOLUTION RL CONTROLLED-ROTATION DILATOR SHEATH SET

MDR report key: 12476998 · Received September 15, 2021

Report

Report Number
2522007-2021-00026
Event Type
Injury
Date Received
September 15, 2021
Date of Event
June 30, 2020
Report Date
February 25, 2022
Manufacturer
COOK VANDERGRIFT INC
Product Code
DRE
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
SI
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

PRODUCT CODE: DRE. PMA/510(K): K141148. THIS REPORT INCLUDES INFORMATION KNOWN AT THIS TIME. A FOLLOW UP REPORT WILL BE SUBMITTED SHOULD ADDITIONAL RELEVANT INFORMATION BECOME AVAILABLE OR UPON COMPLETION OF INVESTIGATION.

Description of Event or Problem · 0

A RECENTLY PUBLISHED ARTICLE IDENTIFIED FOUR POSSIBLE ADVERSE EVENTS WITHIN SLOVENIA. THE ARTICLE DETAILED THAT JUS KSELA AND HIS COLLEAGUES PERFORMED 131 LEADS EXTRACTIONS FROM 2015 THROUGH 2019 AT THE UNIVERSITY MEDICAL CENTER LJUBLJANA. THE RETROSPECTIVE STUDY UTILIZED COOK EVOLUTION RL CONTROLLED-ROTATION DILATOR SHEATH SETS DURING TRANSVENOUS LEAD EXTRACTIONS AND CONCLUDED THE STUDY WITH PROCEDURAL AND CLINICAL SUCCESS RATES OF 92.4% AND 98.5%, RESPECTIVELY. THE PHYSICIANS REPORTED 4 ADVERSE EVENTS OCCURRING INSIDE THE 67-PATIENT AGGREGATE. ONE PATIENT EXPERIENCED WORSENING TRICUSPID VALVE REGURGITATION FROM NONE TO MILD REGURGITATION NOT NECESSITATING ANY FURTHER TREATMENT. THERE WERE NO PATIENT DEATHS IN THE COHORT; THE FOLLOWING COMPLAINTS ARE RELATED: (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1373765 LEAD EXTRACTION EVOLUTION RL CONTROLLED-ROTATION DILATOR SHEATH SET VESSEL DILATOR FOR PERCUTANEOUS CATHETERIZATION DRE COOK VANDERGRIFT INC UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention