FDA Adverse Event Other Summary report: N

LASSO DEFLECTABLE CIRCULAR MAPPING CATHETER

MDR report key: 647009 · Received November 17, 2005

Report

Report Number
2029046-2005-00107
Event Type
Other
Date Received
November 17, 2005
Date of Event
October 17, 2005
Report Date
October 18, 2005
Manufacturer
BIOSENSE WEBSTER
Product Code
DRF
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING AN A-FIB PROCEDURE, THE LASSO CATHETER BECAME STUCK IN THE SMALL BRANCH OF PULMONARY VEIN. THE PHYSICIAN WAS ABLE TO MANIPULATE THE CATHETER AND REMOVE IT WITHOUT SURGERY. NO PT INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LASSO DEFLECTABLE CIRCULAR MAPPING CATHETER DEFLECTABLE MAPPING CATHETER DRF BIOSENSE WEBSTER D7-L10-20-RT UNK

Patients

Seq Age Sex Outcome Treatment
1 NO INFO Life Threatening| R