Catalog Number M490007 |
Device Problem
Patient Device Interaction Problem (4001)
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Patient Problem
Fistula (1862)
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Event Date 08/15/2023 |
Event Type
Injury
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Manufacturer Narrative
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F14.Manufacturer postal code: d-79111.This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by biosense webster inc., or its employees that the report constitutes an admission that the product, biosense webster inc., or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.If additional information is received regarding this event, a supplemental 3500a report will be submitted to the fda.Biosense webster inc.'s reference number pc-(b)(4) has two reports: (1) manufacture report number # 2029046-2023-02882 for product code d134805 (thermocool® smart touch® sf bi-directional navigation catheter).(2) importer report number # for product code m490007 (smartablate¿ system rf generator (us).
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Event Description
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It was reported that a patient underwent an atrial fibrillation (afib) cardiac ablation procedure which included the use of a thermocool® smart touch® sf bi-directional navigation catheter and smartablate¿ system rf generator, and experienced an esophageal fistula and received intervention; however, details are unknown.The only information provided was that the patient suffered an esophageal fistula after the procedure but could not confirm when it happened and any details on how the injury was discovered.The last known status of the patient was stable.No other details or information were provided.The catheter worked as expected with no issues during the procedure.Additional information was provided.The adverse event occurred after the procedure.The physician¿s opinion on the cause of this adverse event was that it was procedure related.Patient has improved.
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Manufacturer Narrative
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The investigation was completed on 26-dec-2023 for the smartablate¿ system rf generator.It was reported that a patient underwent an atrial fibrillation (afib) cardiac ablation procedure which included the use of a thermocool® smart touch® sf bi-directional navigation catheter and smartablate¿ system rf generator, and experienced an esophageal fistula and received intervention; however, details are unknown.The only information provided was that the patient suffered an esophageal fistula after the procedure but could not confirm when it happened and any details on how the injury was discovered.The last known status of the patient was stable.No other details or information were provided.The catheter worked as expected with no issues during the procedure.Additional information was provided.The adverse event occurred after the procedure.The physician¿s opinion on the cause of this adverse event was that it was procedure related.Patient has improved.Investigation details for the smartablate¿ system rf generator: remote support confirmed the unit was performing as intended; therefore, no failure was found with the system.A device history record evaluation was performed for the finished device number, and no internal actions related to the reported complaint condition were identified.Additionally, the manufactured date has been provided.Therefore, field h4.Device manufacture date has been populated.All devices are manufactured, inspected, and released to approved specifications as part of biosense webster's quality process.If additional information is received regarding this event, a supplemental 3500a report will be submitted to the fda.Biosense webster inc.'s reference number (b)(4) has two reports: (1) manufacture report number # 2029046-2023-02882 for product code d134805 (thermocool® smart touch® sf bi-directional navigation catheter) (2) importer report number # 2029046-2023-50018 for product code m490007 (smartablate¿ system rf generator.(us)).
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Search Alerts/Recalls
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