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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EDWARDS LIFESCIENCES SWAN GANZ BIPOLAR PACING CATHETER FOR FEMORAL INSERTION; ELECTRODE, PACEMAKER, TEMPORARY

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EDWARDS LIFESCIENCES SWAN GANZ BIPOLAR PACING CATHETER FOR FEMORAL INSERTION; ELECTRODE, PACEMAKER, TEMPORARY Back to Search Results
Model Number PE075F5
Device Problem Pacing Problem (1439)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Event Description
It was reported that a swan ganz catheter was unable to pace from the beginning of use.The issue was resolved by replacing the catheter.Information such as the background of malfunction occurrence, what kind of surgery or examination the catheter was used for, if the patient had cardiac conduction defect, and date of event is unknown.Patient demographic information was requested but unavailable.The device was discarded at the hospital due to infection.There were no patient complications reported.
 
Manufacturer Narrative
The device was not returned for evaluation.Device was discarded due to exposure to infection.Without return of the unit it is not possible to determine if some damage or defect existed on the unit that could have contributed to the event.It is not known if some procedural factors may have contributed to the event.Further evaluation regarding related quality issues is under investigation.The lot number was not provided thus a device history record was not reviewed.Complaint histories for all reported events are reviewed against trending control limits on a monthly basis and any excursions above the control limits are assessed and documented as a part of the monthly review.
 
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Brand Name
SWAN GANZ BIPOLAR PACING CATHETER FOR FEMORAL INSERTION
Type of Device
ELECTRODE, PACEMAKER, TEMPORARY
Manufacturer (Section D)
EDWARDS LIFESCIENCES
1 edwards way
irvine CA 92614
Manufacturer (Section G)
EDWARDS LIFESCIENCES
1 edwards way
irvine CA 92614
Manufacturer Contact
jonathan diaz
1 edwards way
irvine, CA 92614
MDR Report Key16106366
MDR Text Key307512695
Report Number2015691-2023-09994
Device Sequence Number1
Product Code LDF
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K813521
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 01/05/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/05/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberPE075F5
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received12/20/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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