FDA Adverse Event Injury Summary report: N

HF SENSOR DELIVERY SYSTEM

MDR report key: 18181554 · Received November 21, 2023

Report

Report Number
3004936110-2023-01440
Event Type
Injury
Date Received
November 21, 2023
Date of Event
October 25, 2023
Report Date
January 30, 2024
Manufacturer
ST. JUDE MEDICAL, INC.
Product Code
MOM
UDI-DI
05414734509237
PMA / PMN Number
P100045
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A REVIEW OF THE INFORMATION PROVIDED WAS PERFORMED, AND THE SENSOR WAS WITHIN THE TOLERANCE FOR CM MEAN; THEREFORE, THE REPORTED MALFUNCTION IS UNCONFIRMED. THIS REPORTED EVENT WAS INVESTIGATED FOR POSSIBLE INACCURATE READING. BASED ON THE INFORMATION GIVEN AND BACKEND LOG ANALYSIS, IT WAS CONFIRMED THAT THE DEVICE WAS OPERATING WITHIN THE EXPECTED FREQUENCY RANGE OF 30-37.5 MHZ. THE SENSOR WAS OPERATING AT 34.7, 34.4, AND 34.7 MHZ DURING THE REVIEW OF THE APPLICABLE READING(S). A REVIEW OF THE DEVICE HISTORY RECORD WAS PERFORMED TO ENSURE THAT EACH MANUFACTURING AND INSPECTION OPERATION WAS PERFORMED. THE REVIEW DETERMINED THAT NO NON-CONFORMANCES WERE IDENTIFIED THAT ARE RELATED TO THE REPORTED EVENT.

Description of Event or Problem · 0

A RIGHT HEART CATHETERIZATION WAS PERFORMED TO CONFIRM THE VALIDITY OF THE PRESSURE SENSOR READINGS. THE SENSOR WAS RECALIBRATED AND THE MEAN INCREASED WAS BY 3.5 MMHG. READINGS WERE OBSERVED UNDER THE MANUFACTURER'S PATIENT CARE NETWORK DATABASE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1855733 HF SENSOR DELIVERY SYSTEM SYSTEM, HEMODYNAMIC, IMPLANTABLE MOM ST. JUDE MEDICAL, INC. CM2000 8692554 05414734509237

Patients

Seq Age Sex Outcome Treatment
1 59 YR Male Hospitalization| R