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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL AMPLATZER MULTI-FENESTRATED SEPTAL OCCLUDER - CRIBRIFORM; TRANSCATHETER SEPTAL OCCLUDER

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ABBOTT MEDICAL AMPLATZER MULTI-FENESTRATED SEPTAL OCCLUDER - CRIBRIFORM; TRANSCATHETER SEPTAL OCCLUDER Back to Search Results
Catalog Number 9-ASD-MF-025
Device Problem Difficult to Fold, Unfold or Collapse (1254)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/13/2023
Event Type  malfunction  
Event Description
It was reported that a 25mm amplatzer septal occluder was selected for implant on (b)(6) 2023 using an 8f amplatzer trevisio intravascular delivery system.During implant it was noted that both discs of the device took on a bulbous shape.There were no interactions with cardiac structures nor were there any angulations or kinks in the delivery system.
 
Manufacturer Narrative
Investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Manufacturer Narrative
An event of device deformity was reported.The device was returned to abbott for investigation and the device met functional specifications when analyzed under non-physiological conditions.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed, and the product met all defined manufacturing specifications.Based on the information received, the cause of the reported event could not be conclusively determined.There is no indication of a product quality issue with respect to labeling design or manufacturing of the device.
 
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Brand Name
AMPLATZER MULTI-FENESTRATED SEPTAL OCCLUDER - CRIBRIFORM
Type of Device
TRANSCATHETER SEPTAL OCCLUDER
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT MEDICAL REG# 2135147
5050 nathan ln n
plymouth MN 55442
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key18121793
MDR Text Key328279107
Report Number2135147-2023-04993
Device Sequence Number1
Product Code MLV
UDI-Device Identifier00811806010298
UDI-Public00811806010298
Combination Product (y/n)N
Reporter Country CodeIT
PMA/PMN Number
P000039
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 01/23/2024
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 Catalogue Number9-ASD-MF-025
Device Lot Number8610677
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/10/2023
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 10/25/2023
Initial Date FDA Received11/13/2023
Supplement Dates Manufacturer Received01/17/2024
Supplement Dates FDA Received01/23/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/11/2022
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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