FDA Adverse Event
Injury
Summary report: N
WATCHMAN FLX? PRO
MDR report key: 22185835
·
Received June 11, 2025
Report
- Report Number
- 2124215-2025-38213
- Event Type
- Injury
- Date Received
- June 11, 2025
- Date of Event
- May 29, 2025
- Report Date
- June 11, 2025
- Manufacturer
- BOSTON SCIENTIFIC CORPORATION
- Product Code
- NGV
- UDI-DI
- 00191506004583
- PMA / PMN Number
- P130013
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VA, US
- Reporter Occupation
- 117
Narratives
Additional Manufacturer Narrative · 0
B3: AWARE DATE WAS USED AS EVENT DATE AS ACTUAL EVENT DATE WAS NOT KNOWN.
Description of Event or Problem · 0
IT WAS REPORTED THAT THROMBOSIS OCCURRED. A LEFT ATRIAL APPENDAGE (LAA) CLOSURE PROCEDURE WAS PERFORMED, AND A 20MM WATCHMAN FLX PRO LAA CLOSURE DEVICE & DELIVERY SYSTEM (WDS) WAS SUCCESSFULLY IMPLANTED. THE PATIENT WAS DISCHARGED. DURING A ROUTINE FOLLOW UP COMPUTED TOMOGRAPHY (CT) SCAN AN IMMOBILE, DEVICE RELATED THROMBUS (DRT) WAS NOTED ON THE FACE OF THE CLOSURE DEVICE. THE PATIENT WAS ON DUAL ANTIPLATELET THERAPY AT THE TIME OF THE EVENT. THE PATIENT WILL CONTINUE ON ORAL ANTICOAGULATION (OAC). THE PATIENT IS EXPECTED TO FULLY RECOVER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 102360 | WATCHMAN FLX? PRO | SYSTEM, APPENDAGE CLOSURE, LEFT ATRIAL | NGV | BOSTON SCIENTIFIC CORPORATION | M635WU60200 | 0035639840 | 00191506004583 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 80 YR | Female | Other |