FDA Adverse Event Malfunction Summary report: N

FLEXCATH STEERABLE SHEATH

MDR report key: 2123272 · Received June 14, 2011

Report

Report Number
3002648230-2011-00047
Event Type
Malfunction
Date Received
June 14, 2011
Date of Event
May 18, 2011
Report Date
May 18, 2011
Manufacturer
MEDTRONIC CRYOCATH LP
Product Code
DRA
PMA / PMN Number
K081049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RETURNED AND WAS VISUALLY INSPECTED AND FUNCTIONALLY TESTED. THE REPORTED ISSUE WAS CONFIRMED THROUGH TESTING. DISSECTION SHOWED A LEAKING HEMOSTATIC VALVE.

Description of Event or Problem · 1

DURING A CRYOABLATION PROCEDURE PERFORMED IN (B)(6), AIR WAS NOTICED IN THE FLEXCATH STEERABLE SHEATH (CATHETER INTRODUCER). THE SHEATH WAS REPLACED WITH ANOTHER FLEXCATH STEERABLE SHEATH, AND THE PROCEDURE WAS COMPLETED. THERE WAS NO PATIENT INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FLEXCATH STEERABLE SHEATH CATHETER, STEERABLE DRA MEDTRONIC CRYOCATH LP 3FC12 35328

Patients

Seq Age Sex Outcome Treatment
1