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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL FLEXABILITY¿ABLATION CATHETER, UNI-D, CURVE D; CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER

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ST. JUDE MEDICAL FLEXABILITY¿ABLATION CATHETER, UNI-D, CURVE D; CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER Back to Search Results
Model Number A701157
Device Problem Fracture (1260)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 03/22/2023
Event Type  malfunction  
Event Description
This report is to advise of a catheter fracture noted during analysis.
 
Manufacturer Narrative
One quadripolar, uni-directional, curve d, flexibility ablation catheter was received for evaluation.The catheter shaft was fractured between electrode ring 2 and electrode ring 3.Further investigation revealed that the thermocouple wires were fractured at the same location as the fractured shaft, consistent with the open circuit detected and the reported temperature issue.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed.The review determined the process was performed and completed in accordance with abbott specifications and procedures.The cause of the fractured shaft and wires remains unknown.
 
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Brand Name
FLEXABILITY¿ABLATION CATHETER, UNI-D, CURVE D
Type of Device
CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER
Manufacturer (Section D)
ST. JUDE MEDICAL
parque industrial, zona franca coyol s.a.
edificio #44b, calle 0, avenida 2, coyol
alajuela, costa rica 1897- 4050
CS  1897-4050
Manufacturer (Section G)
ST. JUDE MEDICAL
parque industrial, zona franca coyol s.a.
edificio #44b, calle 0, avenida 2, coyol
alajuela, costa rica 1897- 4050
CS   1897-4050
Manufacturer Contact
janna parks
5050 nathan lane north
plymouth, MN 55442
6517565400
MDR Report Key17003887
MDR Text Key316123549
Report Number3008452825-2023-00219
Device Sequence Number1
Product Code OAD
UDI-Device Identifier05415067011497
UDI-Public05415067011497
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
P110016
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
Report Date 05/25/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received05/25/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model NumberA701157
Device Catalogue NumberA701157
Device Lot Number8588160
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/13/2023
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received05/23/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/28/2022
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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