FDA Adverse Event Injury Summary report: N

BIOSENSE WEBSTER CARTOXP RMT PATIENT INTERFACE

MDR report key: 1672769 · Received April 27, 2010

Report

Report Number
MW5015743
Event Type
Injury
Date Received
April 27, 2010
Date of Event
April 16, 2010
Report Date
April 27, 2010
Manufacturer
BIOSENSE WEBSTER/JOHNSON & JOHNSON
Product Code
DQK
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
AZ, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

CARTOXP RMT ELECTROANATOMIC MAPPING SYSTEM -BIOSENSE WEBSTER- DID NOT RECOGNIZE ABLATION CATHETER WHEN CONNECTED. PT WAS UNDER GENERAL ANESTHESIA, VENOUS ACCESS WAS OBTAINED, AND CATHETERS INSERTED INTO THE HEART. CATHETER ELECTROGRAMS AND SURFACE 12-LEAD EKG TRANSMITTED FROM CARTO TO EP MED RECORDING SYSTEM -ST. JUDE MEDICAL- AND CARTO SOFTWARE SCREEN DISPLAYED GREEN COM-UNIT LIGHTS, BUT COULD NOT REFERENCE THE CATHETER IN 3-D SPACE. GREEN LIGHTS ON CARTO SYSTEM BECAME INTERMITTENT, AND COMMUNICATION TESTING WAS PERFORMED. SYSTEM INTERMITTENTLY PASSED COMMUNICATION TESTING, BUT WOULD THEN FAIL. CARTO REP WAS ALREADY ON SITE FOR CLINICAL CASE SUPPORT. CALLED TECH SUPPORT LINE. VISUAL INSPECTION OF THE FIBEROPTIC -FO- CABLE CONNECTING CARTO COM-UNIT TO PT INTERFACE UNIT -PIU- APPEARED INTACT. REPLACEMENT CABLE WAS USED TO TROUBLESHOOT, AT WHICH POINT EXISTING FO CABLE WAS UNPLUGGED FROM CARTO PIU. PLASTIC FEMALE RECEPTACLE FOR FO CABLE CAME OFF FREELY FROM THE PIU WITH THE MALE FO CABLE PLUG AND COMMUNICATION WITH SYSTEM TERMINATED COMPLETELY. REPLACEMENT PIU REQUIRED PER CARTO FIELD SERVICE ENGINEER, WOULD HAVE TO BE SHIPPED. PROCEDURE ABORTED, PT EMERGED FROM ANESTHESIA AFTER RESOLUTION OF PARALYTIC AGENTS AND TRANSPORTED TO RECOVERY ROOM IN STABLE CONDITION. REPLACEMENT UNIT AND CABLES SENT WITH MODIFIED FO RECEPTACLE AND FO CABLE, AS THIS FRACTURE WITH PREVIOUS STYLE CONNECTION WAS A "KNOWN ISSUE" RESOLVED THROUGH NEW CONNECTION/NEW CABLE. DATES OF USE: (B) (6) 2009 - (B) (6) 2010. DIAGNOSIS OR REASON FOR USE: ELECTROANATOMIC MAPPING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 BIOSENSE WEBSTER CARTOXP RMT PATIENT INTERFACE CARTOXP RMT DQK BIOSENSE WEBSTER/JOHNSON & JOHNSON MANF #: M-5730-01 MANF #: M-5730-01

Patients

Seq Age Sex Outcome Treatment
1 79 YR Other| S ACUNAV/CYPRESS -SIEMENS- INTRACARDIAC ECHO| RECORDING SYSTEM| ARTIS ZEE -SIEMENS- FLUOROSCOPY| SYSTEM| XPER -PHILIPS- HEMODYNAMIC MONITORING SYSTEM| NIOBE/ODYESSY -STEREOTAXIS- MAGNETIC NAVIGATION| EP MED -ST. JUDE MEDICAL- ELECTROPHYSIOLOGY| FABIUSMRI -DRAGER- MRI-COMPATABLE ANESTHESIA| MACHINE| M-SERIES-ZOLL- MONITOR/DEFIBRILLATOR