FDA Adverse Event Injury Summary report: N

ACHIEVE MAPPING CATHETER

MDR report key: 8500832 · Received April 10, 2019

Report

Report Number
3002648230-2019-00268
Event Type
Injury
Date Received
April 10, 2019
Date of Event
January 1, 2019
Report Date
April 10, 2019
Manufacturer
MEDTRONIC CRYOCATH LP
Product Code
DRF
PMA / PMN Number
K102588
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

CONCOMITANT MEDICAL PRODUCTS: FLEXCATH ADVANCE STEERABLE SHEATH MEDTRONIC 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. THIS EVENT OCCURRED OUTSIDE THE US. ALL INFORMATION PROVIDED IS INCLUDED IN THIS REPORT. PATIENT INFORMATION IS LIMITED DUE TO CONFIDENTIALITY CONCERNS. OF NOTE, MULTIPLE PATIENTS WERE NOTED IN THE ARTICLE; HOWEVER, A ONE TO ONE CORRELATION COULD NOT BE MADE WITH UNIQUE PRODUCT SERIAL/LOT NUMBERS. THE BASELINE GENDER/AGE CHARACTERISTICS IS MALE/(B)(6) YEARS OLD. 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. A REQUEST FOR ADDITIONAL INFORMATION WILL BE MADE AND UPON RECEIPT A SUPPLEMENTAL REPORT WILL BE SUBMITTED ACCORDINGLY. REFERENCED ARTICLE: ¿DIFFERENCES IN PROTHROMBOTIC RESPONSE BETWEEN THE UNINTERRUPTED AND INTERRUPTED APIXABAN THERAPIES IN PATIENTS UNDERGOING CRYOBALLOON ABLATION FOR PAROXYSMAL ATRIAL FIBRILLATION: A RANDOMIZED CONTROLLED STUDY.¿ HEART AND VESSELS. 2019; DOI:10.1007/S00380-019-01370-9. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

THE LITERATURE PUBLICATION REPORTED THE FOLLOWING PATIENT COMPLICATIONS DURING THE USE OF A CATHETER ABLATION SYSTEM. OF NOTE, MULTIPLE PATIENTS WERE NOTED IN THE ARTICLE; HOWEVER, A ONE TO ONE CORRELATION COULD NOT BE MADE WITH UNIQUE PRODUCT SERIAL/LOT NUMBERS. THERE WERE FOUR (4) PATIENTS WITH HEMATOMAS AT THE PUNCTURE SITE; WHICH DID NOT REQUIRE ANY INTERVENTION. THERE WAS ONE (1) PATIENT WHO EXPERIENCED PERICARDIAL EFFUSION/CARDIAC TAMPONADE; WHICH REQUIRED PERICARDIOCENTESIS. THERE WAS ONE (1) PATIENT WHO HAD VASCULAR COMPLICATIONS, WHICH REQUIRED SURGICAL INTERVENTION. THE STATUS/LOCATION OF THE SYSTEM IS UNKNOWN. FURTHER FOLLOW UP DID NOT YET YIELD ANY ADDITIONAL INFORMATION. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
293147 ACHIEVE MAPPING CATHETER CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING DRF MEDTRONIC CRYOCATH LP 990063-015

Patients

Seq Age Sex Outcome Treatment
1 66 YR Hospitalization| L| R ARCTIC FRONT ADVANCE CARDIAC CRYOABLATION CATHETER