MITRACLIP? SYSTEM CLIP DELIVERY SYSTEM CDS0602-NTR

MAUDE Adverse Event Report

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 2020-03-30 for MITRACLIP? SYSTEM CLIP DELIVERY SYSTEM CDS0602-NTR manufactured by Abbott Vascular.

Event Text Entries

[188560849] The additional clip delivery system is filed under a separate medwatch report number. The device was not returned for analysis. A review of the lot history record revealed no manufacturing nonconformities issued to the reported lot that would have contributed to this event. Based on the information provided the endocarditis is the result of procedure conditions. The reported septic embolism is the result of the endocarditis. The reported fever and infection (meningitis) are the result of the septic embolism. The reported patient effects of fever, embolism, endocarditis, and infection (meningitis), as listed in the mitraclip system instructions for use, are known possible complications associated with mitraclip procedures. There is no indication of a product issue with respect to manufacture, design, or labeling.
Patient Sequence No: 1, Text Type: N, H10


[188560850] This is being filed to report the endocarditis. It was reported that this was a mitraclip procedure to treat functional mitral regurgitation (mr) with a grade of 3. Two ntr clips were implanted, reducing mr to 1-2. On (b)(6) 2020, the patient was rehospitalized with fever and meningitis related to septic embolism. A transesophageal echocardiography (tee) was performed which showed vegetation on the mitral valve. The patient remains hospitalized and treated with medication. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-03060
MDR Report Key9896789
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-30
Date of Report2020-03-30
Date of Event2020-03-03
Date Mfgr Received2020-03-06
Device Manufacturer Date2019-10-01
Date Added to Maude2020-03-30
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 ContactMS. LINDSEY BELL
Manufacturer Street26531 YNEZ RD.
Manufacturer CityTEMECULA CA 925914628
Manufacturer CountryUS
Manufacturer Postal925914628
Manufacturer Phone9519143996
Manufacturer G1ABBOTT VASCULAR, REG # 3005070406
Manufacturer Street3885 BOHANNON DRIVE
Manufacturer CityMENLO PARK CA 94025
Manufacturer CountryUS
Manufacturer Postal Code94025
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameMITRACLIP? SYSTEM CLIP DELIVERY SYSTEM
Generic NameVALVE REPAIR
Product CodeNKM
Date Received2020-03-30
Catalog NumberCDS0602-NTR
Lot Number91001U102
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerABBOTT VASCULAR
Manufacturer Address26531 YNEZ RD. TEMECULA CA 925914628 US 925914628


Patients

Patient NumberTreatmentOutcomeDate
101. Hospitalization; 2. Required No Informationntervention 2020-03-30

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