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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MPRI ARCTIC FRONT ADVANCE CARDIAC CRYOABLATION CATHETER; PERCUTANEOUS CATHETER INTENDED FOR TREATMENT OF ATRIAL FIBRILLATION

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MPRI ARCTIC FRONT ADVANCE CARDIAC CRYOABLATION CATHETER; PERCUTANEOUS CATHETER INTENDED FOR TREATMENT OF ATRIAL FIBRILLATION Back to Search Results
Model Number 2AF284
Device Problems Gas/Air Leak (2946); Material Twisted/Bent (2981)
Patient Problem No Consequences Or Impact To Patient (2199)
Event Date 08/27/2020
Event Type  malfunction  
Manufacturer Narrative
If information is provided in the future, a supplemental report will be issued.
 
Event Description
It was reported that during a cryo ablation procedure, when trying to pull back heme, if the physician pulled the syringe too fast, air was introduced.The sheath was replaced.The physician is not sure if the sheath or balloon catheter were causing the air ingress issue.The case was completed with cryo.No patient complications have been reported as a result of this event.
 
Manufacturer Narrative
Product event summary: the balloon catheter 2af284 with lot number 00486 was returned and analyzed.Visual inspection showed wrinkles at the shaft.X-ray imaging confirmed shaft deformation but did not show any broken braided wires.X-ray imaging showed a guide wire lumen kink.As received, the catheter was inserted into the received sheaths.For both, difficulty engaging the catheter was noticed due to the kink.Dissection showed a guide wire lumen kink at the balloon section.A pressure test did not show the guide wire lumen was breached.In conclusion, the reported air ingress was not confirmed, however the balloon catheter failed the returned product inspection due to a guide wire lumen kink.Medtronic is submitting this report to comply with fda reporting regulations under 21 cfr parts 4 and 803.This report is based upon information obtained by medtronic, which the company may not have been able to fully investigate or verify prior to the date the report was required by the fda.Medtronic has made reasonable efforts to obtain more complete information and has provided as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.In particular, this report does not constitute an admission by anyone that the product described in this report has any ¿defects¿ or has ¿malfunctioned¿.These words are included in the fda 3500a form and are fixed items for selection created by the fda to categorize the type of event solely for the purpose of regulatory reporting.Medtronic objects to the use of these words and others like them because of the lack of definition and the connotations implied by these terms.This statement should be included with any information or report disclosed to the public under the freedom of information act.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.A good faith effort will be made to obtain the applicable information relevant to the report.If information is provided in the future, a supplemental report will be issued.
 
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Brand Name
ARCTIC FRONT ADVANCE CARDIAC CRYOABLATION CATHETER
Type of Device
PERCUTANEOUS CATHETER INTENDED FOR TREATMENT OF ATRIAL FIBRILLATION
Manufacturer (Section D)
MPRI
road 149 km 56.3
villalba PR 00766
MDR Report Key10536366
MDR Text Key207012791
Report Number2649622-2020-17703
Device Sequence Number1
Product Code OAE
UDI-Device Identifier00643169878365
UDI-Public00643169878365
Combination Product (y/n)N
PMA/PMN Number
P100010/S015
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,health
Type of Report Initial,Followup
Report Date 10/30/2020
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date02/26/2021
Device Model Number2AF284
Device Catalogue Number2AF284
Device Lot Number00486
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/01/2020
Initial Date Manufacturer Received 08/27/2020
Initial Date FDA Received09/15/2020
Supplement Dates Manufacturer Received10/08/2020
Supplement Dates FDA Received10/30/2020
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
Treatment
4FC12 SHEATH; 4FC12 SHEATH
Patient Age60 YR
Patient Weight91
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