This is filed to report soft tip damage.It was reported that this was a mitraclip procedure to treat degenerative mitral regurgitation (mr) with grade 4.The steerable guide catheter (sgc) was inserted into the groin without issue, but resistance was felt and was unable to advance through the septum.It was decided to remove the sgc and use a new dilator.The first and second dilator were advanced without issue.The sgc was reinserted and advanced up to the septum but could not cross the septum.Therefore, the sgc was removed from the patient anatomy.Outside the patient anatomy it was noted that the soft tip was damaged, the soft tip appeared to have a peak (stretched) but no tear was visible.A new sgc was advanced without issue.During preparation of the clip delivery system (cds), the clip established final arm angle (efaa) successfully, but the clip would not open after.Multiple attempts were made but the clip remained closed.There was no patient involvement with this cds.Two clips were implanted successfully, reducing mr to 1.There was no adverse patient effect and no clinically significant delay in the procedure.No additional information was provided.
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The returned device analysis confirmed the reported deformation due to compressive stress.The reported failure to advance could not be replicated in a testing environment as it was related to procedural/operational circumstances.A review of the lot history record identified no manufacturing nonconformities issued to the reported lot that would have contributed to the reported event.Additionally, a review of the complaint history did not indicate a lot-specific product issue.All available information was investigated and a cause for the reported failure to advance the steerable guide catheter (sgc) resulting in the deformed (stretched) soft tip cannot be determined.There is no indication of a product issue with respect to manufacture, design or labeling.Na.
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