WATCHMAN LAA CLOSURE DEVICE & DELIVERY SYSTEM 10371

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative,health report with the FDA on 2020-03-18 for WATCHMAN LAA CLOSURE DEVICE & DELIVERY SYSTEM 10371 manufactured by Boston Scientific Corporation.

Event Text Entries

[184163126] (b)(6) study. It was reported that the patient experienced a transient ischemic attack. On (b)(6) 2019, a left atrial appendage (laa) closure procedure was performed. A watchman access system (was) was positioned and a 21mm watchman laa closure device & delivery system (wds) were used. The subject underwent successful placement of a 21 mm watchman laac device with complete laa seal and deployed device diameter of 18. 6 mm. Prior to the procedure, aspirin was administered and after the implant the subject was started on clopidogrel. The subject was discharged on (b)(6) 2019. On (b)(6) 2020, 316 days post index procedure, the subject had symptoms of dizziness, and worsened in a standing position. The subject had difficulty in equilibrium and seemed to be stumbling or off balance. Additional information received from their spouse revealed that the subject might have had a fall the previous day due to their imbalance but there was no head trauma or loss of consciousness. On the same day, the subject was hospitalized for further treatment and evaluation. In the emergency department, the subject was hypertensive and bradycardic but otherwise hemodynamically stable and was started on aspirin, lipitor and dapt therapy. The subject was evaluated for speech and swallow function and recommended expressive language training to improve ability to express wants and needs, and cognitive treatment to improve cognition. A magnetic resonance imaging (mri) was performed on the same day which revealed a punctate signal involving a left frontal gyrus which may reflect a subacute infarct. There were multiple foci of t2 and flair white matter subcortical and periventricular hyperintensities, non-specific but likely secondary to small vessel disease. On the same day a computed tomography (ct) head scan was performed which revealed no acute intracranial abnormality and no acute intracranial hemorrhage. At the time of evaluation, the subject was asymptomatic and there were no focal neurologic deficits. The subjects condition improved with the treatment. On (b)(6) 2020, the event was considered to be resolved and the subject was discharged on the same day.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2134265-2020-03451
MDR Report Key9851199
Report SourceCOMPANY REPRESENTATIVE,HEALTH
Date Received2020-03-18
Date of Report2020-03-18
Date of Event2019-11-21
Date Mfgr Received2020-02-25
Device Manufacturer Date2018-10-31
Date Added to Maude2020-03-18
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 ContactJAY JOHNSON
Manufacturer StreetTWO SCIMED PLACE
Manufacturer CityMAPLE GROVE MN 55311
Manufacturer CountryUS
Manufacturer Postal55311
Manufacturer Phone7634942574
Manufacturer G1BOSTON SCIENTIFIC CORPORATION
Manufacturer StreetBALLYBRIT BUSINESS PARK
Manufacturer CityGALWAY
Manufacturer CountryEI
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameWATCHMAN LAA CLOSURE DEVICE & DELIVERY SYSTEM
Generic NameSYSTEM, APPENDAGE CLOSURE, LEFT ATRIAL
Product CodeNGV
Date Received2020-03-18
Model Number10371
Catalog Number10371
Lot Number0022871041
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerBOSTON SCIENTIFIC CORPORATION
Manufacturer AddressTWO SCIMED PLACE MAPLE GROVE MN 55311 US 55311


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2020-03-18

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