FDA Adverse Event Injury Summary report: N

SHOCKWAVE C2 CORONARY INTRAVASCULAR LITHOTRIPSY (IVL) SYSTEM

MDR report key: 17195184 · Received June 23, 2023

Report

Report Number
3015053858-2023-00037
Event Type
Injury
Date Received
June 23, 2023
Date of Event
May 28, 2023
Report Date
March 28, 2024
Manufacturer
SHOCKWAVE MEDICAL, INC.
Product Code
QMG
UDI-DI
00195451000096
PMA / PMN Number
P200039
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THE DEVICES REFERENCED IN THIS REPORT WERE NOT RETURNED TO SHOCKWAVE MEDICAL, INC. AFTER THE PROCEDURE THEREFORE, A PHYSICAL INVESTIGATION COULD NOT BE PERFORMED. BASED ON THE LIMITED PROVIDED INFORMATION, POST INDEX PERCUTANEOUS CORONARY INTERVENTION (PCI) PROCEDURE, THE PATIENT EXPERIENCED ANGINA AND LATER FOUND A DISSECTION. THE DISSECTION WAS TREATED WITH STENT IMPLANTATION. TWO DAYS LATER, THE PATIENT WAS REPORTED TO HAVE A HEART FAILURE REDUCED EJECTION FRACTION (EF). A REVIEW OF THE LOT HISTORY RECORD (LHR) AND TEST DOCUMENTATION DID NOT SHOW ANY ISSUES WITH THE MANUFACTURING OF THE DEVICE. THE DEVICE PASSED ALL SHOCKWAVE MEDICAL, INC. CRITERIA PRIOR TO BEING RELEASED FOR DISTRIBUTION. 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. 2ND DEVICE USED DURING THE INDEX PROCEDURE: CP-11327 LOT NUMBER: A220915D EXPIRATION DATE: 09/30/2024 MANUFACTURNG DATE: 09/15/2022.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION RECEIVED ON 05MAR2024: A CEC ADJUDICATION HEARING WAS CONDUCTED AND IT WAS DETERMINED THAT THE REPORTED ADVERSE EVENT, UNSTABLE ANGINA, WAS ADJUDICATED AS MYOCARDIAL INFARCTION (MI). THE MI HAS BEEN CEC ADJUDICATED TO BE POSSIBLY RELATED TO THE STUDY DEVICE. THE ADVERSE EVENT OCCURRED AT THE TIME OF THE INDEX PROCEDURE. THE CAUSE OF THE MYOCARDIAL INFARCTION COULD NOT BE DETERMINED WITH THE AVAILABLE INFORMATION AND THERE WAS NO MALFUNCTION REPORTED FOR THE C2 IVL CATHETERS THAT WERE USED.

Description of Event or Problem · 0

IT WAS REPORTED THAT TWO SHOCKWAVE C2IVL CORONARY LITHOTRIPSY (IVL) CATHETERS WERE USED ON THIS PATIENT. REPORTEDLY, POST INDEX PERCUTANEOUS CORONARY INTERVENTION (PCI) PROCEDURE FOR THE POST MARKET EMPOWER CAD CLINICAL STUDY, PATIENT # 112, 001 WAS REPORTED TO HAVE EXPERIENCED 9/10 CHEST PAIN RADIATING TO THE RIGHT JAW. CARDIAC ANGIOGRAM SHOWED ST DEPRESSIONS AND THE PATIENT WAS GIVEN NITROGLYCERIN BUT WITHOUT RELIEF. INTRAVENOUS TRINDIL DRIP WAS STARTED AND WHEN THE PATIENT WAS BROUGHT BACK TO THE CATH LAB, THERE WAS A LAB DISSECTION OBSERVED. THE PHYSICIAN TREATED THE DISSECTION WITH RX STENTS X 4. THE PATIENT WAS TRANSFERRED TO THE CARDIOTHORACIC INTENSIVE CARE UNIT (CTICU). TWO DAYS LATER, THE PATIENT WAS REPORTED TO HAVE A HEART FAILURE REDUCED EJECTION FRACTION (EF). IT WAS REPORTED TO HAVE BEEN TREATED WITH MEDICATION. ECHOCARDIOGRAM POST PCI EF WAS 40% (BASELINE WAS 64%), HEART FAILURE CONSULTED. THE PATIENT WAS WARM AND WELL PERFUSED, BUT VOLUME WAS OVERLOADED. PATIENT WAS ADVISED TO CONTINUE CARDIAC MEDICATION (HYDRALAZINE) TO ALLOW FOR INCREASE FLUID REMOVAL. THE PATIENT'S EF WAS ALSO ASSOCIATED WITH ORTHOPNEA (SENSATION OF BREATHLESSNESS).

Description of Event or Problem · 0

ADDITIONAL INFORMATION RECEIVED ON 05MAR2024: A CEC ADJUDICATION HEARING WAS CONDUCTED AND IT WAS DETERMINED THAT THE REPORTED ADVERSE EVENT, UNSTABLE ANGINA, WAS ADJUDICATED AS MYOCARDIAL INFARCTION (MI). THE MI HAS BEEN CEC ADJUDICATED TO BE POSSIBLY RELATED TO THE STUDY DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1279206 SHOCKWAVE C2 CORONARY INTRAVASCULAR LITHOTRIPSY (IVL) SYSTEM INTRAVASCULAR LITHOTRIPSY (IVL) CATHETER QMG SHOCKWAVE MEDICAL, INC. C2IVL3012 A220915D 00195451000096

Patients

Seq Age Sex Outcome Treatment
1 72 YR Female Other