MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05 report with the FDA on 2013-01-28 for 3D SNDSTR10 SNDSTR10CO manufactured by Stryker Sustainability Solutions Phoenix.
[3121439]
It was reported, "the device perforated the right ventricle because of difficulty in steering. " procedure was suspended after the perforation. Two taps were done to remove fluid, but this was unsuccessful, the patient coded and was then taken into the operating room to repair the perforation.
Patient Sequence No: 1, Text Type: D, B5
[10418284]
The complaint device was not returned to stryker sustainability solutions (sss) for an evaluation. Stryker sustainability solutions' instructions for use (ifu) state: do not exert excessive pressure during placement of catheter if unknown resistance is encountered. Vascular damage, including perforation, is a small but inherent risk. Carefully manipulate the catheter in order to avoid cardiac damage, perforation, or tamponade. If encountering strong resistance during catheter articulation, discontinue the procedure and determine the cause of the resistance before proceeding. Inspect the catheter for overall condition and physical integrity. Do not use the catheter if any damage is noted. If such problems exist, return the catheter and packaging to stryker sustainability solutions. Rotate the steering control knobs. The function should be smooth and the catheter tip should flex in a corresponding direction up to 160?. The tension control knob is completely released by rotating fully counter clockwise. For proper care and handling of the ultrasound catheter, always hold the ultrasound catheter by the handle and support the catheter shaft. Avoid touching the ultrasound catheter interconnect tab. Avoid excessive kinking or bending of catheter, as this may interfere with distal tip shaping. Since the device was not returned for an evaluation a root cause could not be determined. However, some potential root causes could be: improper curve as a result of mishandling prior/subsequent to distribution from stryker (includes user storage methods). Articulation wire failure/fatigue as a result of mishandling prior/subsequent to distribution from stryker (includes user storage methods). User error (includes user technique and methods). User expectation of the anticipated articulation configuration. Ancillary equipment error (includes all other equipment outside of the complaint device that may have contributed to the error). The reported event is not occurring more frequently or with greater severity than is usual for the device.
Patient Sequence No: 1, Text Type: N, H10
| Report Number | 0002090040-2013-00001 |
| MDR Report Key | 2931944 |
| Report Source | 05 |
| Date Received | 2013-01-28 |
| Date of Report | 2013-01-02 |
| Date of Event | 2012-12-26 |
| Date Mfgr Received | 2013-01-02 |
| Date Added to Maude | 2013-01-29 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 0 |
| Event Location | 0 |
| Manufacturer Contact | MR. MOIRA BARTON VARTY |
| Manufacturer Street | 1810 W DRAKE DRIVE |
| Manufacturer City | TEMPE AZ 85283 |
| Manufacturer Country | US |
| Manufacturer Postal | 85283 |
| Manufacturer Phone | 4807635300 |
| Manufacturer G1 | STRYKER SUSTAINABILITY SOLUTIONS PHOENIX |
| Manufacturer Street | 1810 W DRAKE DRIVE |
| Manufacturer City | TEMPE AZ 85283 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 85283 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | 3D |
| Generic Name | NLI |
| Product Code | OWQ |
| Date Received | 2013-01-28 |
| Model Number | SNDSTR10 |
| Catalog Number | SNDSTR10CO |
| Lot Number | UNKNOWN |
| ID Number | SNDSTR10 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | STRYKER SUSTAINABILITY SOLUTIONS PHOENIX |
| Manufacturer Address | 1810 W DRAKE DRIVE TEMPE AZ 85283 US 85283 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2013-01-28 |