FDA Adverse Event Injury Summary report: N

RFIRMAP CATHETER, 70MM

MDR report key: 3764594 · Received April 10, 2014

Report

Report Number
3009385307-2014-00002
Event Type
Injury
Date Received
April 10, 2014
Date of Event
March 11, 2014
Report Date
April 9, 2014
Manufacturer
MEDFACT ENGINEERING GMBH
Product Code
DRF
Adverse Event
Yes
Report Source
Distributor report
Reporter Location
PA, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

ON (B)(6) 2014, THE PATIENT EXPERIENCED A PERICARDIAL EFFUSION REQUIRING PERICARDIOCENTESIS AND TRANSFUSION DURING A CARDIAC ABLATION PROCEDURE. THE ABLATION DEVICE, IN ITS OWN SHEATH, WAS LOCATED IN THE LEFT ATRIAL APPENDAGE. THE PHYSICIAN STRUGGLED WITH DEPLOYMENT OF THE 70MM FIRMAP CATHETER, BUT SUCCESSFULLY DEPLOYED IT USING A DEFLECTABLE SHEATH. A SINGLE LEFT ATRIAL MAP WAS TAKEN WITH THE 70MM FIRMAP. DURING MAP REVIEW, THE PHYSICIAN NOTICED THAT A SYSTEMIC BLOOD PRESSURE DROP OCCURRED. THE PATIENT EXPERIENCED PERICARDIAL EFFUSION DUE TO WHAT WAS LATER DESCRIBED AS A "WIRE HOLE" PERFORATION IN THE LEFT ATRIAL APPENDAGE CAUSED MECHANICALLY BY THE ABLATION CATHETER. THE PATIENT REQUIRED PERICARDIOCENTESIS AND TRANSFUSION. APPROXIMATELY 1500CC OF BLOOD IN TOTAL WERE DRAINED. THE PATIENT WAS THEN TAKEN TO THE OPERATING ROOM FOR DEFINITIVE SURGERY, SUTURE CLOSURE OF THE PERFORATION IN THE LEFT ATRIAL APPENDAGE. FOLLOWING TREATMENT THE PATIENT WAS REPORTED TO BE IN STABLE AND GOOD CONDITION. REFERENCE MFR # 3008497357-2014-00002.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
216161 RFIRMAP CATHETER, 70MM MAPPING CATHETER DRF MEDFACT ENGINEERING GMBH US-AR064070 USAR064070221113

Patients

Seq Age Sex Outcome Treatment
1 66 YR Hospitalization THERMOCOOL ABLATION CATHETER| AGILIS STEERABLE SHEATH