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

[188672460] The device is expected to be returned for evaluation. It has not yet been received. A follow up report will be submitted with all additional relevant information.
Patient Sequence No: 1, Text Type: N, H10


[188672461] This is being filed to report the clip jumping, inability to close the clip, and difficulty removing the device requiring surgical removal. It was reported that this was a mitraclip procedure to treat functional mitral regurgitation (mr) with a grade of 1. The clip delivery system (cds) was advanced above the mitral valve and an attempt was made to open the clip; however was unsuccessful. Then the clip suddenly jumped open to 180 degrees. The clip could only be turned in the open direction. All curves were removed from the cds and the clip was able to be closed to 20 degrees. The clip was then maneuvered directly onto the lip of the steerable guide catheter (sgc). When trying to pull the entire system over the septum, the clip arms opened again. The whole system was retracted to the groin where a vascular surgeon was called to remove the clip. The procedure was aborted with the mr remaining at 1. There was no clinically significant delay in the procedure and no adverse patient sequela.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-03066
MDR Report Key9897214
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-30
Date of Report2020-03-30
Date of Event2020-03-10
Date Mfgr Received2020-03-10
Device Manufacturer Date2019-04-26
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 Number90425U277
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
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. Required No Informationntervention 2020-03-30

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