MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a study report with the FDA on 2020-02-28 for CARDIOBLATE G2 68000 manufactured by Perfusion Systems.
[187736365]
If information is provided in the future, a supplemental report will be issued.
Patient Sequence No: 1, Text Type: N, H10
[187736366]
The patient had a concomitant surgical procedure of aortic valve replacement, mitral valve replacement through sternotomy. During the same procedure ((b)(6) 2019) a cryoflex probe powered by a cryoconsole, and a cardioblate lp clamp powered by a cardioblate generator were used. The left atrial appendage was successfully amputated/excised and sutured closed. Left pulmonary vein (pv) and right pulmonary vein (pv) conduction block was not achieved due to patient being in atrial fibrillation. On the day after the procedure ((b)(6) 2019) the patient needed reintubation which was treated with concomitant/additional medication and prolonged hospitalization. The patient recovered ((b)(6) 2019). The adverse event was deemed by the site as causally related to the concomitant procedure and unlikely related to the study devices and the study procedure. This is much more likely to be related to the double valve procedure.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2184009-2020-00011 |
| MDR Report Key | 9769105 |
| Report Source | STUDY |
| Date Received | 2020-02-28 |
| Date of Report | 2020-04-01 |
| Date of Event | 2019-10-30 |
| Date Mfgr Received | 2020-03-03 |
| Device Manufacturer Date | 2006-05-01 |
| Date Added to Maude | 2020-02-28 |
| 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 | PAULA BIXBY |
| Manufacturer Street | 8200 CORAL SEA STREET NE |
| Manufacturer City | MOUNDS VIEW MN 55112 |
| Manufacturer Country | US |
| Manufacturer Postal | 55112 |
| Manufacturer Phone | 7635055378 |
| Manufacturer G1 | PERFUSION SYSTEMS |
| Manufacturer Street | 7611 NORTHLAND DR |
| Manufacturer City | BROOKLYN PARK MN 55428 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 55428 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | CARDIOBLATE G2 |
| Generic Name | SURGICAL DEVICE, FOR ABLATION OF CARDIAC TISSUE |
| Product Code | OCL |
| Date Received | 2020-02-28 |
| Model Number | 68000 |
| Catalog Number | 68000 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | PERFUSION SYSTEMS |
| Manufacturer Address | 7611 NORTHLAND DR BROOKLYN PARK MN 55428 US 55428 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-02-28 |