FDA Adverse Event Malfunction Summary report: N

FLEXCATH STEERABLE SHEATH

MDR report key: 2183208 · Received July 28, 2011

Report

Report Number
3002648230-2011-00098
Event Type
Malfunction
Date Received
July 28, 2011
Date of Event
June 29, 2011
Report Date
June 29, 2011
Manufacturer
MEDTRONIC CRYOCATH LP
Product Code
DRA
PMA / PMN Number
K081049
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, 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. A FIELD ACTION WAS INITIATED IN (B)(4) 2011 TO COMMUNICATE TO PHYSICIANS AND REGULATORY AUTHORITIES THIS POTENTIAL LEAK IN HEMOSTATIC VALVE OF MEDTRONIC CRYOCATH FLEXCATH 12 STEERABLE SHEATHS.

Description of Event or Problem · 1

DURING A CRYOABLATION PROCEDURE, THERE WAS A LEAK FROM THE VALVE OF THE FLEXCATH STEERABLE SHEATH AND AIR BUBBLES WERE SUCKED IN THROUGH THE SIDE PORT DURING THE ASPIRATION PROCESS. 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 35329

Patients

Seq Age Sex Outcome Treatment
1