IMPELLA
Report
- Report Number
- 1220648-2026-07816
- Event Type
- Death
- Date Received
- May 14, 2026
- Date of Event
- May 7, 2026
- Manufacturer
- ABIOMED, INC. - 1220648
- Product Code
- OZD
- UDI-DI
- 00813502012279
- PMA / PMN Number
- P140003
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER HEALTH CARE PROFESSIONAL
- Health Professional
- Yes
Narratives
THIS IS ONE OF TWO RELATED REPORTS. THIS REPORT REPRESENTS THE IMPELLA CP AND ANOTHER REPORT WAS SUBMITTED TO REPRESENT THE GUIDEWIRE. THIS REPORT IS BEING SUBMITTED PURSUANT TO THE PROVISIONS OF 21 CFR, PART 803. THIS REPORT MAY BE BASED ON INFORMATION WHICH HAS NOT BEEN INVESTIGATED OR VERIFIED PRIOR TO THE REQUIRED REPORTING DATE. THIS REPORT DOES NOT REFLECT A CONCLUSION BY ABIOMED INC, OR ITS EMPLOYEES THAT THE REPORT CONSTITUTES AN ADMISSION THAT THE PRODUCT, ABIOMED INC, OR ITS EMPLOYEES CAUSED OR CONTRIBUTED TO THE POTENTIAL EVENT DESCRIBED IN THIS REPORT. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE.
THIS FOLLOW-UP REPORT IS BEING SUBMITTED TO DOCUMENT THAT THE DEVICE HAS BEEN RETURNED TO THE MANUFACTURER FOR INVESTIGATION. SECTION D9 HAS BEEN UPDATED TO REFLECT THAT THE PRODUCT WAS RETURNED FOR INVESTIGATION.
CLINICAL NARRATIVE: AN IMPELLA CP WAS INSERTED VIA THE RIGHT FEMORAL ARTERY TO SUPPORT AN 80-YEAR-OLD MALE PATIENT WHO HAD BEEN ADMITTED IN WITH ACUTE MYOCARDIAL INFARCTION AND CARDIOGENIC SHOCK, PRESENTING IN SCAI STAGE E SHOCK. THE OTHER UNDERLYING MEDICAL HISTORY WAS NOT SHARED. THE CP WAS DELIVERED TO THE LEFT VENTRICLE FOR SUPPORT OVER THE .018 GUIDEWIRE AS PER BEST PRACTICES. THE WIRE WAS THEN BEING REMOVED, BUT THE TEAM WAS UNABLE TO DO SO. THE ENTIRE SYSTEM OF WIRE AND PUMP WERE REMOVED AND REPLACED BY A NEW 2ND CP PUMP. THE TEAM OBSERVED THE WIRE HAD KINKED AND WAS STUCK IN THE CANNULA OF THE PUMP. THE PATIENT EXPIRED ON THE 2ND DAY OF THE REPLACEMENT CP PUMP SUPPORT. THE OFFICIAL CAUSE OF DEATH HAS BEEN SHARED AS CARDIAC ARREST. THE TEAM NOTED THE CP WAS NOT ENOUGH SUPPORT, THE PATIENT'S UNDERLYING CONDITION WAS DISCUSSED WITH THE FAMILY. THE FAMILY MADE DECISION NOT TO ESCALATE AND ADD RIGHT SIDED IMPELLA SUPPORT. THE FAMILY MADE DECISION TO WITHDRAW CARE AND PATIENT EXPIRED AFTER BEING MADE A DNR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 466289 | IMPELLA | TEMPORARY NON-ROLLER TYPE LEFT HEART SUPPORT BLOOD PUMP | OZD | ABIOMED, INC. - 1220648 | 2027831430 | 00813502012279 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 80 YR | Male | Death| R |