FDA Adverse Event Injury Summary report: N

IMPELLA

MDR report key: 25176227 · Received May 14, 2026

Report

Report Number
1220648-2026-07858
Event Type
Injury
Date Received
May 14, 2026
Date of Event
May 10, 2026
Report Date
May 14, 2026
Manufacturer
ABIOMED, INC. - 1220648
Product Code
OZD
UDI-DI
00813502012279
PMA / PMN Number
P140003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NH, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

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.

Additional Manufacturer Narrative · 0

H6: UPDATED CODES BASED ON THE RESULTS OF THE INVESTIGATION. H11: UPDATED BASED ON THE RESULTS OF THE INVESTIGATION AND ADDED CLINICAL REVIEW. CORRECTED INFORMATION HAS BEEN PROVIDED IN D3( MANUFACTURER FAX); E4 UPON REVIEW, IT WAS IDENTIFIED THAT THE INFORMATION WAS INADVERTENTLY NOT SUBMITTED IN THE INITIAL REPORT. THE ROOT CAUSE OF THE INJURY WAS UNABLE TO BE DETERMINED DUE TO INSUFFICIENT CLINICAL DETAILS.

Description of Event or Problem · 0

AN IMPELLA CP DEVICE WAS INSERTED INTO THE RIGHT FEMORAL ARTERY IN A 62-YEAR-OLD MALE PATIENT PRESENTING IN ACUTE MYOCARDIAL INFARCTION (AMI) AND CARDIOGENIC SHOCK (CGS), IN CARDIAC ARREST REQUIRING CARDIOPULMONARY RESUSCITATION (CPR), IN SCAI STAGE C SHOCK, ON MULTIPLE INOTROPES AND VASOPRESSORS, AND ON A VENTILATOR FOR RESPIRATORY SUPPORT, PRIOR TO INITIATION OF SUPPORT. THE IMPELLA WAS INSERTED FOR VENTRICULAR SUPPORT FOR A PROTECTED PERCUTANEOUS CORONARY INTERVENTION (PCI) OF THE LEFT CIRCUMFLEX ARTERY. WHILE THE PATIENT WAS IN THE INTENSIVE CARE UNIT (ICU), PULSES WERE LOST IN THE IMPELLA LEG, REQUIRING A RADIAL/FEMORAL BYPASS REPERFUSION SHEATH TO BE PLACED. THE POST-PROCEDURE OUTCOME IS UNKNOWN. THE IMPELLA FUNCTIONED AT P-2 AT 2.0L/MIN AS INTENDED. THE REPORTED LIMB ISCHEMIA CAN BE ATTRIBUTED TO THE PATIENT'S HIGH-DOSE VASOPRESSOR SUPPORT, COMPLICATED BY THE UNDERLYING CARDIOGENIC SHOCK.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
291218 IMPELLA TEMPORARY NON-ROLLER TYPE LEFT HEART SUPPORT BLOOD PUMP OZD ABIOMED, INC. - 1220648 2027855483 00813502012279

Patients

Seq Age Sex Outcome Treatment
1