FDA Adverse Event Death Summary report: N

TACTICATH¿ CONTACT FORCE ABLATION CATHETER, SENSOR ENABLED¿

MDR report key: 8529889 · Received April 18, 2019

Report

Report Number
3005334138-2019-00211
Event Type
Death
Date Received
April 18, 2019
Date of Event
March 29, 2019
Report Date
July 16, 2019
Manufacturer
ST. JUDE MEDICAL
Product Code
OAE
PMA / PMN Number
P130026
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 0

CORRECTED INFORMATION: DATE RECEIVED BY MFR. AN EVENT OF A CARDIAC ARREST AND PATIENT DEATH WAS REPORTED. THE RESULTS OF THE INVESTIGATION ARE INCONCLUSIVE SINCE THE DEVICE WAS NOT RETURNED FOR ANALYSIS. BASED ON THE INFORMATION RECEIVED, THE CAUSE OF THE REPORTED INCIDENT COULD NOT BE CONCLUSIVELY DETERMINED.

Additional Manufacturer Narrative · 0

THE RESULTS OF THE INVESTIGATION ARE INCONCLUSIVE SINCE THE DEVICE WAS NOT RETURNED FOR ANALYSIS. BASED ON THE INFORMATION RECEIVED, THE CAUSE OF THE CARDIAC PERFORATION AND PATIENT DEATH COULD NOT BE CONCLUSIVELY DETERMINED.

Additional Manufacturer Narrative · 1

THE RESULTS/METHOD AND CONCLUSION CODES ALONG WITH INVESTIGATION RESULTS WILL BE PROVIDED IN A SUBSEQUENT SUBMISSION. FURTHER INFORMATION REGARDING TREATMENT, DATE OF PATIENT DEATH AND HOW THE ADVERSE EVENT WAS CONFIRMED WAS REQUESTED BUT NOT RECEIVED.

Description of Event or Problem · 1

RELATED MFG NUMBERS: 3008452825-2019-00149, 2030404-2019-00023, 2030404-2019-00024, AND 2182269-2019-00045. FOLLOWING AN ATRIAL FIBRILLATION ABLATION PROCEDURE, THE PATIENT WENT INTO CARDIAC ARREST AND SUBSEQUENTLY PASSED AWAY. AFTER THE PROCEDURE WAS COMPLETED AND ALL THE SHEATHS, CATHETERS, AND INTRODUCERS WERE REMOVED, THE PATIENT WENT INTO CARDIAC ARREST AND EMERGENCY MEDICAL MEASURES WERE TAKEN. THE PATIENT SUBSEQUENTLY EXPIRED A FEW DAYS AFTER THE EVENT DUE TO UNKNOWN CAUSES. FURTHER INFORMATION HAS BEEN REQUESTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
319064 TACTICATH¿ CONTACT FORCE ABLATION CATHETER, SENSOR ENABLED¿ CARDIAC ABLATION PERCUTANEOUS CATHETER OAE ST. JUDE MEDICAL

Patients

Seq Age Sex Outcome Treatment
1 Death AGILIS STEERABLE INTRODUCER| INQUIRY OPTIMA CATHETER| INQUIRY STEERABLE CATHETER| VIEWFLEX IMAGING CATHETER