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U.S. Department of Health and Human Services

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

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EDWARDS LIFESCIENCES SWAN GANZ BIPOLAR PACING CATHETER FOR SVC INSERTION; ELECTRODE, PACEMAKER, TEMPORARY Back to Search Results
Model Number PE074F5
Device Problem Pacing Problem (1439)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Manufacturer Narrative
The device evaluation is anticipated.However, the complaint cannot be confirmed without the completion of a product evaluation.A supplemental report will be forthcoming with the evaluation and device history results when received.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.
 
Event Description
It was reported that a swan ganz was unable to pace from the beginning of use after catheter insertion.The cable was replaced but the problem was not solved.The issue was resolved by replacing the catheter.Information such as what kind of surgery or examination the catheter was used for, if the patient had cardiac conduction defect, or date of event is unknown.Patient demographic information was requested but unavailable.There were no patient complications reported.
 
Manufacturer Narrative
The report of pacing issue was confirmed.Continuity testing found that the proximal circuit had an intermittent condition around the electrode, when flexing the tip area of the catheter.Distal circuit was continuous without any intermittent or open condition.No short condition was observed between the proximal and distal lead wires.A cut down was performed to isolate the intermittent condition and the intermittent condition was found to be around proximal electrode.The balloon inflated clear and concentric and remained inflated for 5 min.Without leakage.No visible damage was observed from windings, balloon and catheter body.Engineering evaluation was completed.A capa was initiated for this issue and a product risk assessment was needed.A device history record review was completed and documented that device met all specifications upon distribution.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 SVC 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 Key16277716
MDR Text Key308721382
Report Number2015691-2023-10476
Device Sequence Number1
Product Code LDF
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K813521
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 03/23/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/01/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberPE074F5
Device Lot Number64540719
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/30/2023
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received02/06/2023
Was Device Evaluated by Manufacturer? Yes
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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