ZINGER GUIDE WIRE - CRDM LVZRXT180J

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,foreig report with the FDA on 2017-08-09 for ZINGER GUIDE WIRE - CRDM LVZRXT180J manufactured by Medtronic, Inc.

Event Text Entries

[82674852]
Patient Sequence No: 1, Text Type: N, H10


[82674853] It was reported that during the implant procedure after the left ventricular (lv) lead was placed in the vein, the guidewire was att empted to be removed, but it was peeled and broke with a part remaining inside the lead with the distal portion of it out and inside the vein of the coronary sinus. It was only possible to remove one portion of the guidewire at first, while the other portion of the wire was still inside the lead in the vein. Pulling the thread left to peel, the physician managed to remove all of the guidewire without further trouble. It was noted that the guidewire coating was separated from the wire. No patient complications have been reported as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1220452-2017-00075
MDR Report Key6782492
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2017-08-09
Date of Report2017-06-23
Date of Event2017-06-23
Date Mfgr Received2017-06-23
Device Manufacturer Date2016-03-28
Date Added to Maude2017-08-09
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactANNE SCHILLING
Manufacturer Street8200 CORAL SEA ST NE
Manufacturer CityMOUNDS VIEW MN 55112
Manufacturer CountryUS
Manufacturer Postal55112
Manufacturer Phone7635052036
Manufacturer G1MEDTRONIC, INC
Manufacturer Street37A CHERRY HILL DR
Manufacturer CityDANVERS MA 01923
Manufacturer CountryUS
Manufacturer Postal Code01923
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameZINGER GUIDE WIRE - CRDM
Generic NameOCCLUDER, CATHETER TIP
Product CodeDQT
Date Received2017-08-09
Model NumberLVZRXT180J
Catalog NumberLVZRXT180J
Lot NumberG16A02434
Device Expiration Date2019-03-28
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDTRONIC, INC
Manufacturer Address37A CHERRY HILL DR DANVERS MA 01923 US 01923


Patients

Patient NumberTreatmentOutcomeDate
10 2017-08-09

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