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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  
Manufacturer Narrative
The reported event of pacing issue was unable to be confirmed.No visible damage or abnormality was observed from catheter body, balloon, windings and returned syringe.Continuity testing was performed on the distal and proximal circuits and there were no open, intermittent, or short conditions observed.The balloon inflated clear and concentric with 1.3 cc air and the balloon remained inflated for 5 min.Without leakage.Further evaluation regarding related quality issues is under investigation.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 had pacing failure from the beginning of use.It was unable to pace when inserted from the femoral vein.The external pacemaker was replaced but the issue was not resolved and the catheter was removed.It is unknown what kind of surgery or examination the catheter was used for, if the patient had cardiac conduction defect, or date of event.Patient demographic information was requested but unavailable.There were no patient complications reported.
 
Manufacturer Narrative
An engineering evaluation was completed to assess for any manufacturing related processes which could be correlated to the complaint.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 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 Key16428268
MDR Text Key310152503
Report Number2015691-2023-11013
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 Other Health Care Professional
Type of Report Initial,Followup
Report Date 04/21/2023
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 Model NumberPE075F5
Device Lot Number64555179
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/14/2023
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 02/02/2023
Initial Date FDA Received02/23/2023
Supplement Dates Manufacturer Received03/30/2023
Supplement Dates FDA Received04/21/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/10/2022
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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