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 2017-12-07 for ZINGER GUIDE WIRE - CRDM LVZRXT180J manufactured by Medtronic, Inc.
[94494151]
Patient Sequence No: 1, Text Type: N, H10
[94494152]
It was reported that during the implant, after placing the lead in the target vein, the physician was using the support guidewire with the lead and when pulling the guidewire back, it got stuck in the vessel, which was very thin. With the retraction movement, the guidewire stretched and broke into two pieces; one part remained inside the lead and also out of the distal part of the lead, in the vein. The other piece was still in the physician's hand. The physician decided to leave the lead with the guidewire in place and removed the rest of the delivery system. No patient complications have been reported as a result of this event.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1220452-2017-00126 |
| MDR Report Key | 7090986 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2017-12-07 |
| Date of Report | 2019-03-01 |
| Date of Event | 2017-10-25 |
| Date Mfgr Received | 2019-02-27 |
| Device Manufacturer Date | 2015-04-10 |
| Date Added to Maude | 2017-12-07 |
| 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 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | LISA ROBERTSON |
| Manufacturer Street | 8200 CORAL SEA ST NE |
| Manufacturer City | MOUNDS VIEW MN 55112 |
| Manufacturer Country | US |
| Manufacturer Postal | 55112 |
| Manufacturer Phone | 7635262723 |
| Manufacturer G1 | MEDTRONIC, INC |
| Manufacturer Street | 37A CHERRY HILL DR |
| Manufacturer City | DANVERS MA 01923 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 01923 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ZINGER GUIDE WIRE - CRDM |
| Generic Name | OCCLUDER, CATHETER TIP |
| Product Code | DQT |
| Date Received | 2017-12-07 |
| Returned To Mfg | 2017-11-08 |
| Model Number | LVZRXT180J |
| Catalog Number | LVZRXT180J |
| Lot Number | G15A02720 |
| Device Expiration Date | 2018-04-09 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDTRONIC, INC |
| Manufacturer Address | 37A CHERRY HILL DR DANVERS MA 01923 US 01923 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-12-07 |