FDA Adverse Event Death Summary report: N

THERMOCOOL® SMART TOUCH¿ ELECTROPHYSIOLOGY CATHETER

MDR report key: 15570352 · Received October 10, 2022

Report

Report Number
2029046-2022-02465
Event Type
Death
Date Received
October 10, 2022
Date of Event
August 31, 2019
Report Date
October 10, 2022
Manufacturer
BIOSENSE WEBSTER INC
Product Code
LPB
PMA / PMN Number
P030031/S053
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS COMPLAINT IS FROM A LITERATURE SOURCE: POTTER T, HERENDAEL HV, BALASUBRAMANIAM R, WRIGHT M, LATCU DG, AGARWAL SC, ZHANG B, BOO LM, PANI A. SAFETY AND LONG-TERM SUCCESS OF PERSISTENT ATRIAL FIBRILLATION ABLATION USING THERMOCOOL SMARTTOUCH® CATHETER: REAL-WORLD EXPERIENCE. J ATR FIBRILLATION. 2019 AUG 31;12(2):2126. DOI: 10.4022/JAFIB.2126. PMID: 32002110; PMCID: PMC6990050. NO DEVICE WAS RECEIVED FOR ANALYSIS AT THE TIME OF SUBMISSION OF THE INITIAL 3500A. SINCE THE PRODUCT WAS NOT RETURNED FOR ANALYSIS, NO PRODUCT FAILURE ANALYSIS CAN BE CONDUCTED, AND NO DETERMINATION OF POSSIBLE CONTRIBUTING FACTORS COULD BE MADE. DEVICE HISTORY RECORD (DHR) REVIEW CANNOT BE CONDUCTED BECAUSE THE LOT NUMBER WAS NOT PROVIDED BY THE CUSTOMER. THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 4. THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY BIOSENSE WEBSTER, INC., OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, BIOSENSE WEBSTER, INC., OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. B2. DATE OF DEATH - THE EXACT DATE OF DEATH IS UNKNOWN AT THIS TIME AND SO THIS FIELD WAS POPULATED WITH THE AWARENESS DATE. THE ¿SUSPECTED MEDICAL DEVICE¿ REPORTED IN SECTION D OF THIS REPORT IS NOT MARKETED IN USA OR APPROVED BY THE FDA. HOWEVER, IT IS BEING REPORTED AS BIOSENSE WEBSTER CONSIDERS THIS AS A SIMILAR DEVICE TO THERMOCOOL® SMART TOUCH¿ ELECTROPHYSIOLOGY CATHETER APPROVED UNDER PMA # P030031/S053. BIOSENSE WEBSTER MANUFACTURER'S REFERENCE NUMBER PC-001198401 HAS TWO REPORTS: (1) MFR # 2029046-2022-02465 FOR UNKNOWN PRODUCT CODE (2) MFR # 2029046-2022-02466 FOR UNKNOWN PRODUCT CODE.

Additional Manufacturer Narrative · 0

DURING INTERNAL REVIEW OF THIS REPORT, IT WAS DISCOVERED THAT INCORRECT INFORMATION WAS PROVIDED. IF ADDITIONAL INFORMATION IS RECEIVED REGARDING THIS EVENT, A SUPPLEMENTAL 3500A REPORT WILL BE SUBMITTED TO THE FDA. MANUFACTURER'S REF. NO: (B)(4) THE BELOW INFORMATION PROVIDED IS INCORRECT, THIS DEVICE IS MARKETED IN THE US. THE ¿SUSPECTED MEDICAL DEVICE¿ REPORTED IN SECTION D OF THIS REPORT IS NOT MARKETED IN USA OR APPROVED BY THE FDA. HOWEVER, IT IS BEING REPORTED AS BIOSENSE WEBSTER CONSIDERS THIS AS A SIMILAR DEVICE TO THERMOCOOL® SMART TOUCH¿ ELECTROPHYSIOLOGY CATHETER APPROVED UNDER PMA # P030031/S053.

Description of Event or Problem · 0

THIS COMPLAINT IS FROM A LITERATURE SOURCE: POTTER T, HERENDAEL HV, BALASUBRAMANIAM R, WRIGHT M, LATCU DG, AGARWAL SC, ZHANG B, BOO LM, PANI A. SAFETY AND LONG-TERM SUCCESS OF PERSISTENT ATRIAL FIBRILLATION ABLATION USING THERMOCOOL SMARTTOUCH® CATHETER: REAL-WORLD EXPERIENCE. J ATR FIBRILLATION. 2019 AUG 31;12(2):2126. DOI: 10.4022/JAFIB.2126. PMID: 32002110; PMCID: PMC6990050. OBJECTIVE/METHODS/STUDY DATA: TO INVESTIGATE THE REAL-WORLD CLINICAL EXPERIENCE OF PERSISTENT ATRIAL FIBRILLATION (PERSAF) ABLATION USING THE THERMOCOOL SMARTTOUCH® CATHETER WITH CONTACT FORCE (CF)-SENSING ABILITY IN A PROSPECTIVE, MULTICENTER REGISTRY. THE THERMOCOOL SMARTTOUCH® REGISTRY, A PROSPECTIVE, OPEN-LABEL, MULTICENTER, OBSERVATIONAL REGISTRY, WAS DESIGNED TO EVALUATE THE REAL-WORLD SAFETY AND LONG-TERM SUCCESS OF PERSAF ABLATION USING AN OPEN-IRRIGATED, CF-SENSING CATHETER (THERMOCOOL SMARTTOUCH® CATHETER; BIOSENSE WEBSTER, INC., DIAMOND BAR, CALIFORNIA). DATA WERE COLLECTED BETWEEN AUGUST 30, 2012, AND JUNE 28, 2014, AT 24 CENTERS IN EUROPE, AUSTRALIA, AND CANADA. AN INSTITUTIONAL REVIEW BOARD AND/OR ETHICS COMMITTEE APPROVED THE STUDY AT EACH PARTICIPATING CENTER. THE STUDY WAS CONDUCTED IN ACCORDANCE WITH THE DECLARATION OF HELSINKI AND THE INTERNATIONAL CONFERENCE ON HARMONISATION HARMONISED TRIPARTITE GUIDELINES FOR GOOD CLINICAL PRACTICE. ALL PATIENTS PROVIDED WRITTEN INFORMED CONSENT TO THE STUDY PROTOCOL. LOT, MODEL AND CATALOG NUMBER ARE NOT AVAILABLE, BUT THE SUSPECTED BIOSENSE DEVICE POSSIBLY ASSOCIATED WITH REPORTED ADVERSE EVENTS: 7.5-FR THERMOCOOL SMARTTOUCH® CF-SENSING CATHETER. OTHER BIOSENSE WEBSTER CONCOMITANT DEVICES THAT WERE ALSO USED IN THIS STUDY: -CARTO® 3 SYSTEM (BIOSENSE WEBSTER, INC., DIAMOND BAR, CALIFORNIA). NON-BIOSENSE WEBSTER DEVICES THAT WERE ALSO USED IN THIS STUDY: N /A. ADVERSE EVENT(S) AND PROVIDED INTERVENTIONS: QTY 1 CARDIAC PERFORATION-THE CASE OF CARDIAC PERFORATION OCCURRED AT THE TIME OF MAPPING, AND NO RF ENERGY WAS DELIVERED. QTY 1 ATRIOESOPHAGEAL FISTULA- THE ATRIOESOPHAGEAL FISTULA CASE RESULTED IN DEATH 1 MONTH AFTER THE INDEX ABLATION PROCEDURE AND WAS CONSIDERED PROCEDURE RELATED AND POSSIBLY DEVICE RELATED. AFTER DISCHARGE, THIS PATIENT PRESENTED TO A DIFFERENT INSTITUTION WITH PULMONARY SYMPTOMS AND WAS DIAGNOSED WITH AN ATRIOESOPHAGEAL FISTULA. THE PATIENT¿S ABLATION PROCEDURE, WHICH INVOLVED PVI WITH ADDITIONAL ABLATION OF NON-PV TARGETS, WAS PERFORMED UNDER GENERAL ANESTHESIA WITHOUT THE USE OF ESOPHAGEAL PROBE OR ESOPHAGEAL PREIMAGING BY AN INVESTIGATOR WHO HAD PREVIOUS EXPERIENCE WITH THE STUDY CATHETER. THE PATIENT HAD NO SIGNIFICANT COMORBIDITIES, AND ABLATION PARAMETERS WERE WITHIN NORMAL LIMITS. -QTY 1 STROKE

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2800232 THERMOCOOL® SMART TOUCH¿ ELECTROPHYSIOLOGY CATHETER CARDIAC ABLATION PERCUTANEOUS CATHETER LPB BIOSENSE WEBSTER INC

Patients

Seq Age Sex Outcome Treatment
1 Unknown Life Threatening| D CARTO® 3 SYSTEM (BIOSENSE WEBSTER).