MAUDE Adverse Event Report: BIOSENSE WEBSTER INC CATHETER; CARDIAC ABLATION PERCUTANEOUS CATHETER

Device Problem Activation Failure (3270)

Patient Problem Failure of Implant (1924)

Event Date 12/19/2019

Event Type  malfunction  

Event Description

Catheter would not take points that it should have.

• Brand Name: CATHETER
• Type of Device: CARDIAC ABLATION PERCUTANEOUS CATHETER
• Manufacturer (Section D): BIOSENSE WEBSTER INC; 31 technology drive; suite 200; irvine CA 92618
• MDR Report Key: 16822714
• MDR Text Key: 314087467
• Report Number: 16822714
• Device Sequence Number: 1
• Product Code: LPB
• Combination Product (y/n): N
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: User Facility
• Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date: 04/19/2023,01/13/2020

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 04/27/2023
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: Yes
• Date Report Sent to FDA: 04/19/2023
• Event Location: Outpatient Diagnostic Facility
• Date Report to Manufacturer: 04/27/2023
• Type of Device Usage: Unknown
• Patient Sequence Number: 1
• Patient Age: 27010 DA
• Patient Sex: Male