FDA Adverse Event Death Summary report: Y

SHOCKWAVE INTRAVASCULAR LITHOTRIPSY (IVL) SYSTEM

MDR report key: 16738484 · Received April 13, 2023

Report

Report Number
3015053858-2023-00018
Event Type
Death
Date Received
April 13, 2023
Report Date
February 1, 2022
Manufacturer
SHOCKWAVE MEDICAL, INX.
Product Code
QMG
PMA / PMN Number
P200039
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 0

THE DEVICES REFERENCED IN THIS REPORT WERE NOT RETURNED TO SHOCKWAVE MEDICAL, INC. FOR INVESTIGATION THEREFORE, A PHYSICAL EXAMINATION COULD NOT BE PERFORMED. SWM IS BLINDED FROM KNOWING THE SITE. DUE TO THIS, INFORMATION ON EVENT DATES, CATHETER LOT NUMBERS, AND DEVICES RETURN ARE NOT AVAILABLE. THE LOT NUMBERS WERE NOT AVAILABLE IN THE REGISTRY CASE REPORT FORMS. SHOCKWAVE MEDICAL, INC. HAS CONTROLS IN PLACE TO ENSURE DEVICES ARE BUILT TO APPROVED PROCEDURES AND MEET LOT RELEASE ACCEPTANCE CRITERIA PRIOR TO BEING DISTRIBUTED.

Description of Event or Problem · 0

SHOCKWAVE MEDICAL, INC. (SWM) HAS APPLIED FOR AND WAS GRANTED THE REQUEST FOR A REGISTRY EXEMPTION, (B)(4) FOR DATA ACQUIRED FROM THE NATIONAL CARDIOVASCULAR DATA REGISTRY (NCDR) CATHPCI REGISTRY FOR THE SHOCKWAVE INTRAVASCULAR LITHOTRIPSY (IVL) SYSTEM WITH THE SHOCKWAVE CORONARY (IVL) CATHETER. THIS REPORT IS TO DOCUMENT A TOTAL OF 87 DEATHS THAT WERE REPORTED AS PART OF THE CAD POST APPROVAL STUDY REGISTRY FOR THE PERIOD BETWEEN JANUARY 1 AND MARCH 31. OTHER PATIENT HARMS ASSOCIATED WITH THESE EVENTS INCLUDE CARDIAC RELATED EVENTS (CARDIAC ARREST, CARDIAC TAMPONADE, MYOCARDIAL INFARCTION, CARDIOGENIC SHOCK), PERFORATION, AND PULMONARY EDEMA. SWM IS BLINDED FROM KNOWING THE SITE. DUE TO THIS, INFORMATION ON EVENT DATES, CATHETER LOT NUMBERS, AND DEVICES RETURN ARE NOT AVAILABLE. THE LOT NUMBERS WERE NOT AVAILABLE IN THE REGISTRY CASE REPORT FORMS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1480324 SHOCKWAVE INTRAVASCULAR LITHOTRIPSY (IVL) SYSTEM INTRAVASCULAR LITHOTRIPSU (VL) CATHETER QMG SHOCKWAVE MEDICAL, INX. C2IVLXXXX UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown Death