FDA Adverse Event Malfunction Summary report: N

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

MDR report key: 2081163 · Received April 14, 2011

Report

Report Number
2030404-2011-00099
Event Type
Malfunction
Date Received
April 14, 2011
Date of Event
February 16, 2011
Report Date
March 18, 2011
Manufacturer
ST. JUDE MEDICAL, IRVINE
Product Code
OAD
PMA / PMN Number
P060019
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

WE ARE AWAITING DEVICE RETURN. IF THE DEVICE IS RETURNED FOR EVALUATION, A FOLLOWUP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

IT WAS REPORTED WHILE USING THE CATHETER FOR AN ABLATION PROCEDURE, THE CATHETER STARTED LEAKING FROM THE HANDLE. THE PHYSICIAN REPLACED THE CATHETER TO COMPLETE THE PROCEDURE. THERE WERE NO CONSEQUENCES TO THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 COOL PATH 7F, 1304-CP-7-25-L-AB (USA) THERAPY COOL PATH ABLATION OAD ST. JUDE MEDICAL, IRVINE 84309 3285255

Patients

Seq Age Sex Outcome Treatment
1 51 YR