FDA Adverse Event Injury Summary report: N

FREEZER CARDIAC CRYOABLATING CATHETER

MDR report key: 653106 · Received December 15, 2005

Report

Report Number
3002648230-2005-00008
Event Type
Injury
Date Received
December 15, 2005
Date of Event
November 15, 2005
Report Date
December 15, 2005
Manufacturer
CRYOCATH TECHNOLOGIES, INC.
Product Code
NFC
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

Narratives

Description of Event or Problem · 1

A PATIENT UNDERGOING ABLATION FOR AVNRT HAD A BRIEF HEART BLOCK DURING MAPPING DUE TO CATHETER MANIPULATION, THEN HAD ANOTHER HEART BLOCK DURING CRYOABLATION. THE PROCEDURE WAS INTERRUPTED. 2:1 CONDUCTION RETURNED IN ABOUT AN HOUR AND COMPLETE AV CONDUCTION RETURNED IN ABOUT FOUR (4) HOURS. THE PT WAS DOING WELL AND NO PACEMAKER WAS REQUIRED. THE DEVICE DID NOT MALFUNCTION BUT ITS CONTRIBUTION CANNOT BE RULED OUT. THE EVENT CONSTITUTES A SERIOUS INJURY BECAUSE THE ABLATION PROCEDURE WAS TERMINATED PRIOR TO COMPLETION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FREEZER CARDIAC CRYOABLATING CATHETER CADIOVASCULAR DEVICE (CRYOCATHETER) NFC CRYOCATH TECHNOLOGIES, INC. 217F3 UNK

Patients

Seq Age Sex Outcome Treatment
1 18 YR Other