MAUDE MDR 5131835

MDR report key
5131835
Report number
3002648230-2015-00336
Event key
0
Event type
3
Date of event
2015-09-25
Date received
2015-10-07
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
1
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
ANNE SCHILLING
Address
8200 CORAL SEA ST NE MOUNDS VIEW MN 55112 US
Phone
763-763-7635
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ACHIEVE ELECTRICAL CABLECABLEMEDTRONIC CRYOCATH LPISN990066990066U531N R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12015-10-070

Event Narratives#

N

Patient 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. THIS DEVICE WAS INCLUDED IN THAT FIELD ACTION. BASED ON THE INFORMATION RECEIVED AND WITHOUT THE RETURN OF THE PRODUCT, IT COULD NOT DETERMINE THIS DEVICE PERFORMED AS DESCRIBED IN THE FIELD ACTION. (B)(4)

D

Patient 1

IT WAS REPORTED THAT PRIOR TO USE, MULTIPLE MAPPING CATHETER ELECTRICAL CABLES WERE RECEIVED MISSING THE OUTER BOX SEAL. IT WAS NOTED THAT UPON OPENING THE CATHETERS, THERE WAS A BREACHED INNER STERILE PACKAGE WITH CABLES THAT WERE LABELED WITH TAPE. THE CABLES WERE REPLACED AND NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

N

Patient 1

N

Patient 1

(B)(4)

N

Patient 1

PRODUCT EVENT SUMMARY: THE ACHIEVE ELECTRICAL CABLE WAS RETURNED AND ANALYZED. THE CABLE WAS RECEIVED IN ITS ORIGINAL PACKAGING BOX WITH A MISSING TAMPERING SEAL AND AN OPENED STERILE PACKAGE POUCH. VISUAL INSPECTION OF THE CABLE SHOWED THAT THE DEVICE WAS INTACT WITH NO APPARENT ISSUES. IT WAS NOTED THAT SOME UNITS WERE OBSERVED WITH A HAND WRITTEN TAG AND MASKING TAPE. NO PERFORMANCE TESTING WAS CONDUCTED WITH THESE UNITS. ALSO, THE UNITS WERE FOR QUALIFICATION TESTING AND WERE NOT INTENDED CLINICAL USE. A PRODUCT HOLD ORDER (PHO) AND A FIELD ACTION WAS INITIATED. IN CONCLUSION, THE REPORTED ISSUE OF THE COMPROMISED AND OPENED PACKAGING WAS CONFIRMED THROUGH TESTING. THE CABLE FAILED THE INSPECTION DUE TO AN OPEN BOX AND POUCH.

N

Patient 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.