FDA Adverse Event Malfunction Summary report: N

COOL PATH 7F, 1304-CP-7-25-L1-AB

MDR report key: 3102326 · Received April 30, 2013

Report

Report Number
2030404-2013-00034
Event Type
Malfunction
Date Received
April 30, 2013
Date of Event
April 2, 2013
Report Date
April 2, 2013
Manufacturer
ST. JUDE MEDICAL, INC. (AF-IRVINE)
Product Code
OAD
PMA / PMN Number
P060019
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS IN THE PROCESS OF BEING ANALYZED. WHEN OUR INVESTIGATION HAS BEEN COMPLETED A FOLLOW-UP REPORT WILL BE SUBMITTED.

Description of Event or Problem · 1

DURING A KENT FASCICLE ABLATION PROCEDURE USING A THERAPY COOL PATH ABLATION CATHETER, THE IRRIGATION PORT OF THE CATHETER WAS LEAKING. APPROXIMATELY 30 MINUTES INTO THE PROCEDURE AFTER SEVERAL SUCCESSFUL LESIONS WERE PLACED, THE PHYSICIAN NOTED THE POWER ON THE GENERATOR WOULD NOT GO ABOVE 2 WATTS. VISUAL ASSESSMENT OF THE CATHETER REVEALED THE IRRIGATION PORT WAS BROKEN AND LEAKING. THERE WERE NO CONSEQUENCES FOR THE PATIENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
188002 COOL PATH 7F, 1304-CP-7-25-L1-AB CARDIAC ABLATION PERCUTANEOUS CATHETER OAD ST. JUDE MEDICAL, INC. (AF-IRVINE) 83505 3556225

Patients

Seq Age Sex Outcome Treatment
1 FAST CATH INTRODUCER (406108/LOT UNKNOWN)