FDA Adverse Event Injury Summary report: N

THMCL SMARTTOUCH,TC,F,C3

MDR report key: 7676221 · Received July 10, 2018

Report

Report Number
2029046-2018-01780
Event Type
Injury
Date Received
July 10, 2018
Date of Event
February 10, 2015
Report Date
June 15, 2018
Manufacturer
BIOSENSE WEBSTER INC
Product Code
LPB
UDI-DI
10846835009002
PMA / PMN Number
P030031/S053
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PHYSICIAN

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. MANUFACTURER'S REF. NO: (B)(4).

Description of Event or Problem · 1

THIS COMPLAINT IS FROM A LITERATURE SOURCE. THIS EVENT IS ORIGINALLY REPORTED IN MFR REPORT # 2029046-2018-01681. ADDITIONAL INFORMATION WAS RECEIVED FROM AUTHOR ON (B)(6) 2018 REGARDING PATIENT #3 AND THEREFORE SUBMITTED SEPARATELY. IT WAS REPORTED THAT ONE (B)(6) MALE PATIENT (PATIENT #3, (B)(6)) UNDERWENT RADIOFREQUENCY ABLATION FOR SYMPTOMATIC,PAROXYSMAL ATRIAL FIBRILLATION USING SMARTTOUCH THERMOCOOL ABLATION CATHETER (CATALOG D133602) UNDER NONFLUOROSCOPIC APPROACH ON (B)(6) 2015 AND SUFFERED CARDIAC TAMPONADE REQUIRING PERICARDIOCENTESIS. PATIENT WAS FULLY RECOVERED. THE AUTHOR COMMENTED THAT THE EVENT WAS PROCEDURE RELATED AND RESULTED MILD IMPAIRMENT OF A BODY FUNCTION OR DAMAGE TO A BODY STRUCTURE. TITLE: ¿NONFLUOROSCOPIC CATHETER ABLATION OF PAROXYSMAL ATRIAL FIBRILLATION.¿ THE PURPOSE OF THIS STUDY WAS TO EVALUATE THE SAFETY AND EFFICACY OF INTRACARDIAC ECHO (ICE)-GUIDED PULMONARY VEIN ISOLATION (PVI) WITHOUT FLUOROSCOPY. 481 PATIENTS WERE ENROLLED IN THIS STUDY. THE STUDY WAS CONDUCTED BETWEEN JANUARY 1, 2014 AND MARCH 31, 2016. AN OPEN-IRRIGATED SMARTTOUCH THERMOCOOL ABLATION CATHETER WAS USED IN THIS STUDY, HOWEVER LOT NUMBER WAS UNKNOWN. DIAGNOSTIC CATHETER LASSO TEST CATHETER 7FR,DEF,15MM (CATALOG PRODUCT D-1220-38-S) WAS ALSO USED IN THIS PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
517280 THMCL SMARTTOUCH,TC,F,C3 CARDIAC ABLATION PERCUTANEOUS CATHETER LPB BIOSENSE WEBSTER INC UNK 10846835009002

Patients

Seq Age Sex Outcome Treatment
1 60 YR Life Threatening| R