MAUDE MDR 6793727

MDR report key
6793727
Report number
2025587-2017-01387
Event key
0
Event type
3
Date of event
2017-07-20
Date received
2017-08-15
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
PAULA BIXBY
Address
8200 CORAL SEA STREET 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
1MOSAIC AORTIC BIOPROSTHETIC HEART VALVETIMER, CLOT, AUTOMATEDHEART VALVES SANTA ANAGKN30530521N R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-08-1501. R

Event Narratives#

N

Patient 1

WITHOUT THE RETURN OF THE PRODUCT, NO DEFINITIVE CONCLUSION CAN BE MADE REGARDING THE CLINICAL OBSERVATION. A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

D

Patient 1

MEDTRONIC RECEIVED INFORMATION THAT APPROXIMATELY 10 YEARS POST IMPLANT OF THIS AORTIC BIOPROSTHETIC VALVE, IT WAS REPLACED WITH A NON MEDTRONIC DEVICE, DUE TO INCREASED SEVERITY OF TISSUE VALVE STENOSIS. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED.

N

Patient 1

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

N

Patient 1

PRODUCT ANALYSIS: UPON RECEIPT AT MEDTRONIC?S QUALITY LABORATORY, THE VALVE WAS DISTORTED; OVAL SHAPED WITH DEFLECTED STENT POSTS. SMALL NEEDLE HOLES IN THE SEWING RING SHOWED PLACEMENT OF IMPLANTATION SUTURES. THE SEWING RING WAS DAMAGED ALL AROUND EXPOSING THE STENT. ALL LEAFLETS WERE IN THE CLOSED POSITION WITH WAVY FREE MARGINS. ALL LEAFLETS WERE FLEXIBLE EXCEPT ON THE AREAS WHERE PANNUS WAS OBSERVED ALONG THE MARGIN OF THE ATTACHMENTS OF ALL LEAFLETS (INFLOW). THE RIGHT CUSP EXHIBITED TAN THROMBOTIC HOST TISSUE AND CALCIFICATION NODULES ON THE INFLOW AND OUTFLOW. THE NON-CORONARY RIGHT COMMISSURE WAS COVERED WITH PANNUS. THE CONDITION OF THE TISSUE OF THE COMMISSURE COULD NOT BE ASSESSED. THE LEFT RIGHT COMMISSURE EXHIBITED SMALL TEARS OF THE LEFT AND RIGHT LEAFLETS. THE NON-CORONARY LEFT WAS INTACT WITH SMALL AMOUNT OF PANNUS ABOVE THE SUPERIOR COAPTIVE AREA. WHITE PANNUS LINED THE INFLOW MARGIN OF ATTACHMENTS ADJACENT TO ALL CUSPS EXTENDING INTO ALL INFERIOR COAPTIVE AREAS, AND EXTENDING 1 TO 5 MM ONTO ALL CUSPS SHOWING A POSSIBLE REDUCED INFLOW ORIFICE AREA. TRACES OF PANNUS WAS OBSERVED ON ALL OUTFLOW RAILS. A LARGE PIECE OF PANNUS WAS EMBEDDED WITH THE SUTURES ALONG THE SEWING CLOTH ADJACENT TO THE NON-CORONARY CUSP. TAN THROMBOTIC HOST TISSUE FILLED AND STIFFENED THE RIGHT CUSP. AN UNKNOWN AMOUNT OF PANNUS APPEARED TO HAVE BEEN REMOVED ON THE INFLOW AND OUTFLOW DURING EXPLANT. NODULES OF CALCIFICATION WERE OBSERVED ON THE INFLOW AND OUTFLOW OF THE RIGHT CUSP. RADIOGRAPHY CONFIRMED CALCIFICATION AT THE RIGHT CUSP AND AT THE LEFT RIGHT COMMISSURE. PATIENT WEIGHT ADDED. IMPLANT DATE ADDED. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.