BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FLEXCATH STEERABLE SHEATH

    MDR report key: 2162443 · Received July 14, 2011

    Report

    Report Number
    3002648230-2011-00081
    Event Type
    Malfunction
    Date Received
    July 14, 2011
    Date of Event
    June 16, 2011
    Report Date
    June 16, 2011
    Manufacturer
    MEDTRONIC CRYOCATH LP
    Product Code
    DRA
    PMA / PMN Number
    K081049
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    PHYSICIAN

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE IS NOT AVAILABLE FOR INVESTIGATION. IT WAS DISCARDED AFTER THE PROCEDURE. THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

    Additional Manufacturer Narrative · 1

    IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

    Description of Event or Problem · 1

    THE ARCTIC FRONT CATHETER WAS INSERTED INTO THE FLEXCATH STEERABLE SHEATH. DURING ASPIRATION, AIR WAS COMING OUT OF THE FLEXCATH SHEATH. THE PHYSICIAN REPLACED THE ARCTIC FRONT CATHETER AND THE FLEXCATH STEERABLE SHEATH AND THE SAME PROBLEM OCCURRED. THE CRYOABLATION PROCEDURE WAS NOT PERFORMED; RF PROCEDURE WAS USED INSTEAD. 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 61 YR