FDA Adverse Event Injury Summary report: N

FLEXCATH ADVANCE STEERABLE SHEATH

MDR report key: 5981477 · Received September 27, 2016

Report

Report Number
3002648230-2016-00415
Event Type
Injury
Date Received
September 27, 2016
Date of Event
January 1, 2016
Report Date
August 31, 2016
Manufacturer
MEDTRONIC CRYOCATH LP
Product Code
DRA
PMA / PMN Number
K081049
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
BE
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CONCOMITANT MEDICAL PRODUCTS: ARCTIC FRONT ADVANCE CARDIAC CRYOABLATION CATHETER. MEDTRONIC CRYOCATH WAS MADE AWARE OF THIS EVENT THROUGH A SEARCH OF LITERATURE PUBLICATIONS. IT WAS NOT POSSIBLE TO ASCERTAIN SPECIFIC DEVICE INFORMATION FROM THE LITERATURE PUBLICATION OR TO MATCH THE EVENT WITH PREVIOUSLY REPORTED EVENTS. THIS INFORMATION IS BASED ENTIRELY ON JOURNAL LITERATURE. THE EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS LIMITED DUE TO CONFIDENTIALITY CONCERNS. MULTIPLE PATIENTS WERE NOTED IN THE ARTICLE; HOWEVER, A ONE TO ONE CORRELATION COULD NOT BE MADE WITH UNIQUE DEVICE SERIAL NUMBERS. THE BASELINE GENDER/AGE CHARACTERISTIC IS MALE/(B)(6) FOR THE PATIENTS REFERENCED IN THE ARTICLE. WITHOUT A LOT NUMBER OR DEVICE SERIAL NUMBER, THE MANUFACTURING DATE CANNOT BE DETERMINED. SINCE NO DEVICE ID WAS PROVIDED, IT IS UNKNOWN IF THIS EVENT HAS BEEN PREVIOUSLY REPORTED. REFERENCED ARTICLE: ¿IMPROVED VISUALISATION OF REAL-TIME RECORDINGS DURING THIRD GENERATION CRYOBALLOON ABLATION: A COMPARISON BETWEEN THE NOVEL SHORT-TIP AND THE SECOND GENERATION DEVICE.¿ J INTERV CARD ELECTROPHYSIOL (2016) 46:307¿314. DOI 10.1007/S10840-016-0114-9.

Description of Event or Problem · 1

THE LITERATURE PUBLICATION REPORTED THE FOLLOWING PATIENT COMPLICATION WHILE USING A SHEATH CATHETER: THERE WAS ONE (1) PATIENT WHO HAD RETRO-PERITONEAL HEMATOMA, WITH UNKNOWN INTERVENTION/OUTCOME. THE STATUS/LOCATION OF THE SHEATH IS UNKNOWN. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
631588 FLEXCATH ADVANCE STEERABLE SHEATH CATHETER, STEERABLE DRA MEDTRONIC CRYOCATH LP 4FC12

Patients

Seq Age Sex Outcome Treatment
1 Other ACHIEVE MAPPING CATHETER