FDA Adverse Event Malfunction Summary report: N

EVOLUT FX DCS

MDR report key: 25331312 · Received May 29, 2026

Report

Report Number
9612164-2026-02807
Event Type
Malfunction
Date Received
May 29, 2026
Date of Event
April 13, 2026
Report Date
May 29, 2026
Manufacturer
MEDTRONIC IRELAND
Product Code
NPT
UDI-DI
00763000822132
PMA / PMN Number
P130021
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

A. SELECT PATIENT INFORMATION CANNOT BE INCLUDED IN THE REGULATORY REPORT DUE TO REGIONAL PRIVACY REGULATIONS. D10. CONTINUATION - CONCOMITANT MEDICAL DEVICES IN USE DURING THE EVENT INCLUDE: MEDTRONIC PRODUCT ID: EVFXPLUS-29; SERIAL #: (B)(6); UBD: (B)(4); IMPLANT DATE: NOT IMPLANTED H6. THE CODES PRESENT IN SECTION H6. CORRESPOND TO MULTIPLE COMPONENTS/PRODUCTS THAT COMPRISE THIS REPORTED EVENT. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

IT WAS REPORTED, DURING PREPARATION FOR THE ATTEMPTED IMPLANT OF THIS 29MM TRANSCATHETER AORTIC BIOPROSTHETIC VALVE (TAV) (R060870), IN A PATIENT WITH A TYPE 0 BICUSPID NATIVE VALVE, AFTER THE TAV WAS LOADED INTO THE DELIVERY CATHETER SYSTEM (DCS) (0013259439) BY AN INEXPERIENCED VALVE LOADER, THE VALVE LOAD WAS REVIEWED VIA FLUOROSCOPIC INSPECTION AND A MISLOAD WAS IDENTIFIED. THE MISLOAD WAS FURTHER CHARACTERIZED AS A BENT STRUT IN THE TAV FRAME WITH NO NODE INVOLVEMENT. THE TAV AND DCS WERE NOT USED FOR THE PROCEDURE. A PRE-IMPLANT BALLOON DILATION WAS PERFORMED AND A SECOND 29MM TAV (R267636) AND DCS (0013259439) WERE LOADED WITHOUT ISSUE. THE DCS WAS INSERTED INTO THE PATIENT¿S VASCULATURE AND ADVANCED TO THE AORTIC ANNULUS. THREE DEPLOYMENT ATTEMPTS WERE MADE; HOWEVER, THE TAV WOULD DISLODGE AND COULD NOT BE IMPLANTED. THE TAV WAS RECAPTURED INTO THE DCS. A DECISION TO ATTEMPT A SMALLER TAV WAS MADE; THEREFORE, THE SYSTEM WAS WITHDRAWN FROM THE PATIENT. A THIRD, SMALLER 26MM TAV (R234758) WAS LOADED INTO A THIRD DCS (0013092710) WITHOUT ISSUE. THE DCS WAS INSERTED INTO THE PATIENT¿S VASCULATURE AND ADVANCED TO THE AORTIC ANNULUS; HOWEVER, THE TAV ALSO DISLODGED DURING THREE SEPARATE DEPLOYMENT ATTEMPTS AND OPTIMAL TAV PLACEMENT COULD NOT BE ACHIEVED. THE TAV WAS RECAPTURED INTO THE DCS AND THE SYSTEM WAS WITHDRAWN FROM THE PATIENT. SUBSEQUENTLY, A 26MM NON-MEDTRONIC (SAPIEN3 UE) TAV WAS USED TO COMPLETE THE PROCEDURE. PER THE PHYSICIAN, THE PATIENT'S BICUSPID VALVE WAS A CONTRIBUTING FACTOR TO THE INABILITY TO PLACE THE MEDTRONIC VALVES. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
22312 EVOLUT FX DCS AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIV NPT MEDTRONIC IRELAND D-EVOLUTFX-2329 0013259439 00763000822132

Patients

Seq Age Sex Outcome Treatment
1