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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EDWARDS LIFESCIENCES INSPIRIS RESILIA AORTIC VALVE; HEART-VALVE, NON-ALLOGRAFT TISSUE

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EDWARDS LIFESCIENCES INSPIRIS RESILIA AORTIC VALVE; HEART-VALVE, NON-ALLOGRAFT TISSUE Back to Search Results
Model Number 11500A23
Device Problem Insufficient Information (3190)
Patient Problem Insufficient Information (4580)
Event Date 03/07/2024
Event Type  Injury  
Manufacturer Narrative
The investigation is still in progress; therefore, a conclusion has yet to be established.A supplemental report will be submitted accordingly upon investigation completion.Edwards will continue to review and monitor all reported events.Trends are monitored on a monthly basis and if action is required, appropriate investigation will be performed.
 
Event Description
It was learned via the patient registry that a patient with a 23mm 11500a inspiris valve underwent a redo aortic valve replacement procedure after an implant duration of one (1) year, six (6) months due to unknown reasons.The explanted valve was replaced with another 23mm 11500a inspiris valve.
 
Manufacturer Narrative
A device history record (dhr) review was not performed, as no information regarding a device failure mode was provided.Furthermore, there is no allegation of a malfunction which could be related to a manufacturing non-conformance and/or one was not suspected or confirmed through investigation; no labeling non-conformance/deficiency; no device-related infection; and no evidence of a product failure with regard to design, reliability, or use error.An engineering evaluation is not required because there is no allegation of a malfunction which could be related to a manufacturing non-conformance and/or one was not suspected or confirmed through investigation; no labeling non-conformance/deficiency; no use-related issue with a hazardous situation; no device-related infection; and no evidence of a product failure with regard to design, reliability, or use error.An ifu review is unable to be performed, as no details regarding failure mode of the device were provided.A capa/scar/pra is not required as there are no confirmed product or labeling non-conformances and no other triggers are met.Based on the information available, a definitive root cause cannot be conclusively determined.
 
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Brand Name
INSPIRIS RESILIA AORTIC VALVE
Type of Device
HEART-VALVE, NON-ALLOGRAFT TISSUE
Manufacturer (Section D)
EDWARDS LIFESCIENCES
1 edwards way
irvine CA 92614
Manufacturer (Section G)
EDWARDS LIFESCIENCES
1 edwards way
irvine CA 92614
Manufacturer Contact
saurav singh
1 edwards way
irvine, CA 92614
9492506615
MDR Report Key19108816
MDR Text Key340229385
Report Number2015691-2024-02847
Device Sequence Number1
Product Code LWR
UDI-Device Identifier00690103194982
UDI-Public(01)00690103194982(17)260323(11)220324
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P150048
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Consumer,Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 05/22/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Model Number11500A23
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 03/21/2024
Initial Date FDA Received04/15/2024
Supplement Dates Manufacturer Received05/15/2024
Supplement Dates FDA Received05/22/2024
Date Device Manufactured03/24/2022
Patient Sequence Number1
Patient Outcome(s) Life Threatening; Required Intervention; Hospitalization;
Patient Age46 YR
Patient SexMale
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