FDA Adverse Event Injury Summary report: N

FARADRIVE

MDR report key: 21683893 · Received March 24, 2025

Report

Report Number
2124215-2025-17642
Event Type
Injury
Date Received
March 24, 2025
Date of Event
February 28, 2025
Report Date
June 30, 2025
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
DRA
UDI-DI
00191506043131
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

IT WAS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION. IF THERE IS ANY FURTHER RELEVANT INFORMATION OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE FILED. UPDATED FIELD B5 WITH NEW INFORMATION OBTAINED. H6 FIELD UPDATED: PATIENT CODE E050301 AIR EMBOLISM CODE ADDED.

Additional Manufacturer Narrative · 0

IT WAS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION. IF THERE IS ANY FURTHER RELEVANT INFORMATION OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE FILED.

Additional Manufacturer Narrative · 0

IT WAS INDICATED THAT THE DEVICE WILL NOT BE RETURNED FOR EVALUATION. IF THERE IS ANY FURTHER RELEVANT INFORMATION OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE FILED. UPDATED FIELD B5 WITH NEW INFORMATION OBTAINED. H6 FIELD UPDATED: PATIENT CODE E050301 AIR EMBOLISM CODE ADDED. UPDATED FIELD B5. CODE E0516 VASOCONSTRICTION REMOVED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT EXPERIENCED A ST SEGMENT ELEVATION. DURING A PULSED FIELD ABLATION (PFA) PROCEDURE TO TREAT AN ATRIAL FIBRILLATION A FARADRIVE WAS SELECTED FOR USE. AFTER PERFORMING A CAVOTRICUSPID ISTHMUS (CTI) ABLATION, THE PATIENT HAD A SPASM AND ST ELEVATION OCCURRED. WHEN THE ISSUE OCCURRED, IT WAS NOTICED THAT AIR HAS APPEARED. A CORONARY ANGIOGRAM (CAG) WAS PERFORMED AND THE ST BECAME STABLE. THE PROCEDURE WAS COMPLETED SUCCESSFULLY. THE DEVICE IS NOT EXPECTED TO RETURN AS IT WAS DISPOSED. IT WAS FURTHER REPORTED THAT ST ELEVATION OCCURRED WHEN THE CATHETER WAS EXCHANGED. IRRIGATION WAS NEVER INTERRUPTED. AIR WAS OBSERVED IN THE LEFT ATRIUM. THE PATIENT HAD FULLY RECOVERED FROM THE EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT EXPERIENCED A ST SEGMENT ELEVATION. DURING A PULSED FIELD ABLATION (PFA) PROCEDURE TO TREAT AN ATRIAL FIBRILLATION A FARADRIVE WAS SELECTED FOR USE. AFTER PERFORMING A CAVOTRICUSPID ISTHMUS (CTI) ABLATION, THE PATIENT HAD A SPASM AND ST ELEVATION OCCURRED. WHEN THE ISSUE OCCURRED, IT WAS NOTICED THAT AIR HAS APPEARED. A CORONARY ANGIOGRAM (CAG) WAS PERFORMED AND THE ST BECAME STABLE. THE PROCEDURE WAS COMPLETED SUCCESSFULLY. THE DEVICE IS NOT EXPECTED TO RETURN AS IT WAS DISPOSED.

Description of Event or Problem · 0

IT WAS REPORTED THAT A PATIENT EXPERIENCED A ST SEGMENT ELEVATION. DURING A PULSED FIELD ABLATION (PFA) PROCEDURE TO TREAT AN ATRIAL FIBRILLATION A FARADRIVE WAS SELECTED FOR USE. AFTER PERFORMING A CAVOTRICUSPID ISTHMUS (CTI) ABLATION, THE PATIENT HAD A SPASM AND ST ELEVATION OCCURRED. WHEN THE ISSUE OCCURRED, IT WAS NOTICED THAT AIR HAS APPEARED. A CORONARY ANGIOGRAM (CAG) WAS PERFORMED AND THE ST BECAME STABLE. THE PROCEDURE WAS COMPLETED SUCCESSFULLY. THE DEVICE IS NOT EXPECTED TO RETURN AS IT WAS DISPOSED. IT WAS FURTHER REPORTED THAT ST ELEVATION OCCURRED WHEN THE CATHETER WAS EXCHANGED. IRRIGATION WAS NEVER INTERRUPTED. AIR WAS OBSERVED IN THE LEFT ATRIUM. THE PATIENT HAD FULLY RECOVERED FROM THE EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1131858 FARADRIVE VASCULAR GUIDE-CATHETER, SINGLE-USE DRA BOSTON SCIENTIFIC CORPORATION CL13555 00191506043131

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Required Intervention