FDA Adverse Event Injury Summary report: N

VERSACROSS CONNECT LAAC ACCESS SOLUTION

MDR report key: 16810066 · Received April 25, 2023

Report

Report Number
2124215-2023-09857
Event Type
Injury
Date Received
April 25, 2023
Date of Event
February 9, 2023
Report Date
May 23, 2023
Manufacturer
BAYLIS MEDICAL COMPANY INC.
Product Code
DXF
UDI-DI
00685447012573
PMA / PMN Number
K150709
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

CORRECTIONS: B1 ADVERSE EVENT/PRODUCT PROBLEM UPDATED FROM ADVERSE EVENT/PRODUCT PROBLEM TO ADVERSE EVENT F10/H6 DEVICE CODES, CHANGED FROM A150204 FAILURE TO ADVANCE TO A24 ADVERSE EVENT WITHOUT IDENTIFIED DEVICE OR USE PROBLEM. IT WAS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION. IF THERE IS ANY FURTHER RELEVANT INFORMATION OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Additional Manufacturer Narrative · 0

PREMARKET / 510(K) # K220414, K150709. IT WAS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION. IF THERE IS ANY FURTHER RELEVANT INFORMATION OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A WATCHMAN LAA PROCEDURE A VERSACROSS CONNECT RF WIRE WAS SELECTED FOR USE. DURING POSITIONING, TENTING WAS PERCEIVED IN AN APPROPRIATE LOCATION ON THE FOSSA OVALE. DURING THE RF TRANSEPTAL PUNCTURE, IT WAS BELIEVED THAT THE DEVICE PUNCTURED THROUGH THE POSTERIOR WALL OF THE RIGHT ATRIUM. ECHO IMAGING WAS INDICATIVE OF AN APPROPRIATE TRAJECTORY AFTER RADIOFREQUENCY ENERGY WAS APPLIED, BUT THERE WAS NO ACCESS TO THE LEFT ATRIUM; IT WAS EVIDENT THAT THE SEPTUM WAS NOT CROSSED. A PERICARDIAL EFFUSION (PE) WAS THEN NOTED IN THE RIGHT ATRIUM. PERICARDIAL EFFUSION RESULTED IN >250CC OF BLOOD LOSS, AND A SIGNIFICANT DROP IN BLOOD PRESSURE AND HEART RATE. THE EFFUSION WAS ROUGHLY 0.59 CM, AFTER THE PROCEDURE, THE EFFUSION WAS NOTICEABLY LARGER. THEREFORE, THE PERICARDIOCENTESIS KIT WAS USED TO DRAIN THE EFFUSION. THE PATIENT COULD NOT BE STABILIZED, SO THEY WERE TRANSPORTED TO THE OPERATING ROOM (OR) FOR CT SURGERY AND BLOOD TRANSFUSION. THE PATIENT RECOVERED AND IS DOING WELL. SINCE THE INITIAL GROIN ACCESS, FORTY MINUTES PASSED UNTIL THE ISSUE WAS ENCOUNTERED. THIS PROCEDURE WAS CANCELLED. THE DEVICE WILL NOT BE RETURNED SINCE IT WAS DISCARDED AT THE FACILITY.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING A WATCHMAN LAA PROCEDURE A VERSACROSS CONNECT RF WIRE WAS SELECTED FOR USE. DURING POSITIONING, TENTING WAS PERCEIVED IN AN APPROPRIATE LOCATION ON THE FOSSA OVALE. DURING THE RF TRANSEPTAL PUNCTURE, IT WAS BELIEVED THAT THE DEVICE PUNCTURED THROUGH THE POSTERIOR WALL OF THE RIGHT ATRIUM. ECHO IMAGING WAS INDICATIVE OF AN APPROPRIATE TRAJECTORY AFTER RADIOFREQUENCY ENERGY WAS APPLIED, BUT THERE WAS NO ACCESS TO THE LEFT ATRIUM; IT WAS EVIDENT THAT THE SEPTUM WAS NOT CROSSED. A PERICARDIAL EFFUSION (PE) WAS THEN NOTED IN THE RIGHT ATRIUM. PERICARDIAL EFFUSION RESULTED IN >250CC OF BLOOD LOSS, AND A SIGNIFICANT DROP IN BLOOD PRESSURE AND HEART RATE. THE EFFUSION WAS ROUGHLY 0.59 CM, AFTER THE PROCEDURE, THE EFFUSION WAS NOTICEABLY LARGER. THEREFORE, THE PERICARDIOCENTESIS KIT WAS USED TO DRAIN THE EFFUSION. THE PATIENT COULD NOT BE STABILIZED, SO THEY WERE TRANSPORTED TO THE OPERATING ROOM (OR) FOR CT SURGERY AND BLOOD TRANSFUSION. THE PATIENT RECOVERED AND IS DOING WELL. SINCE THE INITIAL GROIN ACCESS, FORTY MINUTES PASSED UNTIL THE ISSUE WAS ENCOUNTERED. THIS PROCEDURE WAS CANCELLED. THE DEVICE WILL NOT BE RETURNED SINCE IT WAS DISCARDED AT THE FACILITY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
539793 VERSACROSS CONNECT LAAC ACCESS SOLUTION CATHETER, SEPTOSTOMY DXF BAYLIS MEDICAL COMPANY INC. VXAK0003 VMFA080123 00685447012573

Patients

Seq Age Sex Outcome Treatment
1 Unknown Required Intervention| O