FDA Adverse Event Malfunction Summary report: N

FLEXCATH STEERABLE SHEATH

MDR report key: 2153663 · Received July 7, 2011

Report

Report Number
3002648230-2011-00073
Event Type
Malfunction
Date Received
July 7, 2011
Date of Event
June 8, 2011
Report Date
June 8, 2011
Manufacturer
MEDTRONIC CRYOCATH LP
Product Code
DRA
PMA / PMN Number
K081049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
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, THE FLEXCATH STEERABLE SHEATH (CATHETER INTRODUCER) ALLOWED AIR TO BE ASPIRATED INTO THE SHEATH THROUGH THE SIDE PORT. THE SHEATH WAS REPLACED BY ANOTHER FLEXCATH STEERABLE SHEATH OF THE SAME LOT, AND THE SAME PROBLEM WAS NOTICED. THE CRYOABLATION PROCEDURE WAS COMPLETED AND NO ADVERSE EVENT OCCURRED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FLEXCATH STEERABLE SHEATH CATHETER, STEERABLE DRA MEDTRONIC CRYOCATH LP 3FC12 38074

Patients

Seq Age Sex Outcome Treatment
1 49 YR