MITRACLIP? SYSTEM CLIP DELIVERY SYSTEM CDS0701-NTW

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 CDS0701-NTW manufactured by Abbott Vascular.

Event Text Entries

[188809278] The other additional 2 mitraclips referenced are being filed under a separate medwatch report number. The device was not returned. A review of the lot history record identified no manufacturing nonconformities issued to the reported lot that would have contributed to the reported event. A definitive cause for the reported patient effect of tricuspid stenosis and thrombosis could not be determined. It should be noted that the intended use section of the mitraclip system, instruction for use states:? The mitraclip system is intended for reconstruction of the insufficient mitral valve through tissue approximation. The reported off-label use appears to be related to the use of the mitraclip device on the tricuspid valve; however, it could not be determined if using the mitraclip on the tricuspid valve caused or contributed to the reported difficulties. The reported patient effects of tricuspid stenosis and thrombosis are listed in the mitraclip system instructions for use as known possible complications associated with mitraclip procedures. There is no indication of a product quality issue with respect to manufacture, design or labeling. (b)(4).
Patient Sequence No: 1, Text Type: N, H10


[188809279] This is filed to report thrombosis, stenosis, treatment with medication, and prolonged hospitalization. It was reported that this was a mitraclip procedure to treat functional tricuspid regurgitation (tr) with a grade 4. On (b)(6) 2020, three clips were implanted for off label-use, reducing tr to <1. The next day, imaging revealed thrombosis on the anterior septal region and possibly to the posterior septal region, indicating the thrombosis is across all three clips (00107u222, 91106u225, 91106u244). Additionally, the mean pressure gradient increased to 6mmhg. The stenosis was not treated since the patient did not experience any clinical symptoms. However, blood thinners were administered to the patient in an attempt to treat the thrombosis. The patient will remain hospitalized until the thrombosis is resolved. There was no clinically significant delay in the procedure. No additional information was provided.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2024168-2020-03091
MDR Report Key9898327
Report SourceCOMPANY REPRESENTATIVE,FOREIG
Date Received2020-03-30
Date of Report2020-03-30
Date of Event2020-03-06
Date Mfgr Received2020-03-10
Device Manufacturer Date2020-01-09
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
Model NumberCDS0701-NTW
Catalog NumberCDS0701-NTW
Lot Number00107U222
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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