FDA Adverse Event Injury Summary report: N

NAVISTAR® THERMOCOOL®

MDR report key: 5239602 · Received November 20, 2015

Report

Report Number
2029046-2015-00271
Event Type
Injury
Date Received
November 20, 2015
Date of Event
December 31, 2014
Report Date
November 3, 2015
Manufacturer
BIOSENSE WEBSTER, INC (IRWINDALE)
Product Code
LPB
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

NO DEVICE WAS RECEIVED FOR ANALYSIS AT THE TIME OF SUBMISSION OF THE INITIAL 3500A. SINCE THE PRODUCT WAS NOT RETURNED FOR ANALYSIS, NO PRODUCT FAILURE ANALYSIS CAN BE CONDUCTED AND NO DETERMINATION OF POSSIBLE CONTRIBUTING FACTORS COULD BE MADE. DEVICE HISTORY RECORD (DHR) REVIEW CANNOT BE CONDUCTED BECAUSE THE NO LOT NUMBER WAS PROVIDED] BY THE CUSTOMER. CONCOMITANT PRODUCTS WERE USED DURING THIS STUDY: DECAPOLAR CORONARY SINUS CATHETER, LASSO CIRCULAR MAPPING CATHETER, CARTO MAPPING SYSTEM. OTHER COMPANY¿S DEVICES WERE USED DURING THIS STUDY: BIPOLAR RF CLAMP (ATRICURE INC), LINEAR PEN DEVICE (ISOLATOR PEN AND COOLRAIL, ATRICURE), LEFT ATRIAL APPENDAGE CLIP (ATRICLIP, ATRICURE), 8-F SHEATH (SL0, ST. JUDE MEDICAL). (B)(6). (B)(4).

Description of Event or Problem · 1

THIS COMPLAINT IS FROM A LITERATURE SOURCE. IT WAS REPORTED THAT ONE PATIENT WITH LONGSTANDING PERSISTENT ATRIAL FIBRILLATION UNDERWENT REPEATED RADIOFREQUENCY CATHETER ABLATION USING NAVISTAR THERMOCOOL ABLATION CATHETER AND DEVELOPED FEMORAL PSEUDOANEURYSM WHICH WAS TREATED WITH FIBRIN INJECTION. BASED ON THE FACTS OF THE CASE AND THE AUTHOR'S ASSESSMENT, THERE WERE NO REPORTED MALFUNCTION WITH ANY OF THE BWI CATHETERS AND SYSTEMS USED DURING THE CASE. THUS, THIS EVENT IS UNRELATED TO THE DEVICE AND MOST LIKELY RELATED TO THE PROCEDURE. TITLE: "REPEAT PROCEDURES AFTER HYBRID THORACOSCOPIC ABLATION IN THE SETTING OF LONG STANDING PERSISTENT ATRIAL FIBRILLATION: ELECTROPHYSIOLOGICAL FINDINGS AND 2 YEAR CLINICAL OUTCOME." THE PURPOSE OF THIS STUDY WAS TO DESCRIBE THE ELECTROPHYSIOLOGICAL (EP) FINDINGS AND CLINICAL OUTCOME IN PATIENTS THAT UNDERWENT A REPEAT PROCEDURE AFTER HYBRID AF ABLATION FOR RECURRENT ATRIAL TACHYARRHYTHMIAS. ALL PATIENTS HAVING UNDERGONE REPEAT PERCUTANEOUS RF ABLATION BETWEEN JANUARY OF 2010 AND DECEMBER 2014. SUSPECT DEVICE IS NAVISTAR THERMOCOOL ABLATION CATHETER, HOWEVER CATALOG AND LOT NUMBER ARE UNKNOWN. OTHER SERIOUS ADVERSE EVENTS WERE REPORTED IN THIS ARTICLE WHICH ARE REPORTED TO FDA SEPARATELY: 1 PATIENT PNEUMOTHORAX; 1 PATIENT EPICARDIAL HEMATOMA; 2 PATIENTS PNEUMONIA.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
768742 NAVISTAR® THERMOCOOL® SIMILAR DEVICE NI75TCJH, PMA # P030031 LPB BIOSENSE WEBSTER, INC (IRWINDALE) D-1197-00 UNKNOWN_NAVISTAR THERMO TC

Patients

Seq Age Sex Outcome Treatment
1 61 YR Other| R