FDA Adverse Event Malfunction Summary report: N

MELODY TRANSCATHETER PULMONARY VALVE

MDR report key: 2142543 · Received June 20, 2011

Report

Report Number
2025587-2011-00073
Event Type
Malfunction
Date Received
June 20, 2011
Date of Event
April 22, 2011
Report Date
June 9, 2011
Manufacturer
MEDTRONIC HEART VALVES, INC.
Product Code
NPV
PMA / PMN Number
H080002
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

(B)(4). EVAL METHOD: DEVICE HISTORY REVIEWED. RESULTS: DEVICE HISTORY REVIEW FOUND THE PRODUCT MET SPECIFICATIONS WHEN RELEASED FOR DISTRIBUTION. CONCLUSIONS: CAUSE OF EVENT CANNOT BE DETERMINED. ANALYSIS: NO PRODUCT WAS RETURNED. CONCLUSION: THE DEVICE HISTORY RECORD WAS REVIEWED AND SHOWED THAT THIS VALVE MET ALL MFG SPECIFICATION FOR PRODUCTS RELEASED FOR DISTRIBUTION. NO ISSUES WERE IDENTIFIED THAT WOULD HAVE IMPACTED THIS EVENT. WITHOUT THE RETURN OF THE PRODUCT, NO DEFINITIVE CONCLUSION CAN BE MADE REGARDING THE CLINICAL OBSERVATION SHOULD THE PRODUCT BE RETURNED, A FOLLOW UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

MEDTRONIC RECEIVED INFO THAT THIS BIOPROSTHETIC TRANSCATHETER VALVE, IMPLANTED 2 YEARS, EXHIBITED SEVERAL MINOR (TYPE 1) STENT FRACTURES. THERE WAS NO PLAN FOR INTERVENTION AND THE VALVE REMAINS IMPLANTED. NO ADVERSE PT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MELODY TRANSCATHETER PULMONARY VALVE NPV MEDTRONIC HEART VALVES, INC. PB 10 NA

Patients

Seq Age Sex Outcome Treatment
1 Other