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 2020-03-11 for ADVISOR? HD GRID MAPPING CATHETER, SENSOR ENABLED? D-AVHD-DF16 manufactured by St. Jude Medical.
[183178695]
The results of the investigation are inconclusive since the device was not returned for analysis. Additionally, no lot number was provided so a review of the device history record (dhr) was not possible. Based on the information received, the cause of the reported device entanglement was procedure related.
Patient Sequence No: 1, Text Type: N, H10
[183178696]
During the procedure, the hd grid was difficult to remove from the right ventricle. Additional force was attempted to remove the catheter however, the hd grid was entangled on a non-abbott catheter also located within the right ventricle. Additional force was further applied to remove the hd grid and the non-abbott device fragmented and detached in the heart. The hd grid was successfully removed and a snare was used to remove the fragmented portion of the non-abbott device. The procedure was cancelled. There were no adverse consequences to the patient and no performance issues with the advisor hd grid.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 3005334138-2020-00095 |
| MDR Report Key | 9820979 |
| Report Source | COMPANY REPRESENTATIVE,FOREIG |
| Date Received | 2020-03-11 |
| Date of Report | 2020-03-11 |
| Date of Event | 2020-02-21 |
| Date Mfgr Received | 2020-02-21 |
| Date Added to Maude | 2020-03-11 |
| 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 | STEPHANIE O' SULLIVAN |
| Manufacturer Street | 5050 NATHAN LANE NORTH |
| Manufacturer City | PLYMOUTH MN 55442 |
| Manufacturer Country | US |
| Manufacturer Postal | 55442 |
| Manufacturer Phone | 6517565400 |
| Manufacturer G1 | ST. JUDE MEDICAL |
| Manufacturer Street | 5050 NATHAN LANE NORTH |
| Manufacturer City | PLYMOUTH MN 55442 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 55442 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ADVISOR? HD GRID MAPPING CATHETER, SENSOR ENABLED? |
| Generic Name | CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING |
| Product Code | DRF |
| Date Received | 2020-03-11 |
| Model Number | D-AVHD-DF16 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | N |
| Device Eval'ed by Mfgr | R |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | ST. JUDE MEDICAL |
| Manufacturer Address | 5050 NATHAN LANE NORTH PLYMOUTH MN 55442 US 55442 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-03-11 |