FDA Adverse Event Injury Summary report: N

FLEXCATH ADVANCE STEERABLE SHEATH

MDR report key: 6107474 · Received November 16, 2016

Report

Report Number
3002648230-2016-00487
Event Type
Injury
Date Received
November 16, 2016
Date of Event
January 1, 2014
Report Date
October 20, 2016
Manufacturer
MEDTRONIC CRYOCATH LP
Product Code
DRA
PMA / PMN Number
K081049
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TU
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

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: ADDITIONAL BENEFIT OF CRYOBALLOON-BASED ATRIAL FIBRILLATION ABLATION BEYOND PULMONARY VEIN ISOLATION: MODIFICATION OF GANGLIONATED PLEXI. EUROPACE (2014) 16, 645651. DOI:10.1093/EUROPACE/EUT240.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

THE LITERATURE PUBLICATION REPORTS THE FOLLOWING PATIENT COMPLICATION WHILE USING A SHEATH CATHETER: THERE WERE FIFTEEN (15) PATIENTS WHO EXPERIENCED PERICARDIAL EFFUSION; WITH UNKNOWN OUTCOME/TREATMENT. THE STATUS/LOCATION OF THE SHEATH CATHETER 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
755783 FLEXCATH ADVANCE STEERABLE SHEATH CATHETER, STEERABLE DRA MEDTRONIC CRYOCATH LP 4FC12

Patients

Seq Age Sex Outcome Treatment
1 54 YR Life Threatening| R ARCTIC FRONT CARDIAC CRYOABLATION CATHETER