FDA Adverse Event Malfunction Summary report: N

FFRCT

MDR report key: 8175617 · Received December 18, 2018

Report

Report Number
3011276938-2018-00010
Event Type
Malfunction
Date Received
December 18, 2018
Date of Event
November 14, 2018
Report Date
December 18, 2018
Manufacturer
HEARTFLOW, INC.
Product Code
PJA
UDI-DI
00853341006015
PMA / PMN Number
K161772
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
501

Narratives

Additional Manufacturer Narrative · 1

AS PART OF HEARTFLOW'S QUALITY MONITORING PROCESS, WE IDENTIFIED A POTENTIAL FALSE NEGATIVE AND INFORMED THE ORDERING PHYSICIAN. (B)(4): THE INVESTIGATION IDENTIFIED A POTENTIAL FALSE NEGATIVE IN THE LCX. THIS WAS DUE TO ANALYST ERROR; WHEN EDITED THE REASSESSMENT OF THE ANALYSIS SHOWED A DECREASE IN THE FFRCT VALUE FROM 0.94 TO 0.66 AT THE DISTAL LCX. WHILE HEARTFLOW HAS IDENTIFIED THIS ISSUE, THE PHYSICIAN HAS NOT PROVIDED FEEDBACK, NOR HAS INDICATED A SAFETY EVENT WITH THE PATIENT. NO ADDITIONAL FOLLOW-UP TO THIS MDR IS EXPECTED.

Description of Event or Problem · 1

HEARTFLOW IDENTIFIED A POTENTIAL FALSE NEGATIVE RESULT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1015751 FFRCT HEARTFLOW FFRCT PJA HEARTFLOW, INC. FFRCT 2.27 00853341006015

Patients

Seq Age Sex Outcome Treatment
1 Other