FDA Adverse Event Malfunction Summary report: N

COOL PATH 7F, 1304-CP-7-25-L-AB (USA)

MDR report key: 1854202 · Received September 3, 2010

Report

Report Number
2030404-2010-00118
Event Type
Malfunction
Date Received
September 3, 2010
Date of Event
August 5, 2010
Report Date
August 5, 2010
Manufacturer
ST. JUDE MEDICAL, IRVINE
Product Code
OAD
PMA / PMN Number
P060019
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UT, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

INVESTIGATION OF THE RETURNED DEVICE CONFIRMED A LEAK IN THE HANDLE OF THE CATHETER CAUSED BY THE LUMEN BREAKING AT THE EDGE OF THE CATHETER HANDLE IN THE PROTECTING TUBE. REVIEW OF THE DEVICE HISTORY RECORDS CONFIRMED THERE WAS NO ISSUE RELATED TO COMPLAINT DURING MFG PROCESS. A QUALITY IMPROVEMENT PROJECT WAS INITIATED TO ADDRESS THIS ISSUE. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED DURING THE PROCEDURE, WHILE ABLATING WITH THE CATHETER,THE PHYSICIAN NOTICED SALINE DRIPPING FROM THE HANDLE. THE CATHETER WAS REPLACED WITH NO FURTHER PROBLEMS ON NO CONSEQUENCES TO THE PT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COOL PATH 7F, 1304-CP-7-25-L-AB (USA) NONE OAD ST. JUDE MEDICAL, IRVINE 84309 K26195

Patients

Seq Age Sex Outcome Treatment
1 UNK