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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EDWARDS LIFESCIENCES PR SWAN GANZ BIPOLAR PACING CATHETER FOR FEMORAL INSERTION; CATHETER, FLOW DIRECTED

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EDWARDS LIFESCIENCES PR SWAN GANZ BIPOLAR PACING CATHETER FOR FEMORAL INSERTION; CATHETER, FLOW DIRECTED Back to Search Results
Model Number D97130F5
Device Problem Pacing Problem (1439)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Event Description
It was reported that a swan ganz was unable to pace from the beginning of the procedure during use.The device was used in transcatheter aortic valve implantation, but it was unknown if it was used for purpose of rapid pacing.The issue was resolved by replacing the catheter.The device was discarded at the hospital due to infection.Patient demographic information was requested but unavailable.There were no patient complications reported.
 
Manufacturer Narrative
The device was not returned for evaluation.Device was discarded due to exposure to infection.Without return of the unit it is not possible to determine if some damage or defect existed on the unit that could have contributed to the event.It is not known if some procedural factors may have contributed to the event.No corrective actions will be taken at this time.A device history record review was completed and documented that device met all specifications upon distribution.Complaint histories for all reported events are reviewed against trending control limits on a monthly basis and any excursions above the control limits are assessed and documented as a part of the monthly review.
 
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Brand Name
SWAN GANZ BIPOLAR PACING CATHETER FOR FEMORAL INSERTION
Type of Device
CATHETER, FLOW DIRECTED
Manufacturer (Section D)
EDWARDS LIFESCIENCES PR
state rd indus pk 402 km 1.4
anasco 00610
*  00610
Manufacturer (Section G)
EDWARDS LIFESCIENCES PR
state rd indus pk 402 km 1.4
anasco 00610
*   00610
Manufacturer Contact
jonathan diaz
1 edwards way
irvine, CA 92614
MDR Report Key17991182
MDR Text Key326366510
Report Number2015691-2023-17018
Device Sequence Number1
Product Code DYG
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K822723
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Foreign,User Facility
Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date 10/23/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/23/2023
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberD97130F5
Device Lot Number64752341
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Date Manufacturer Received10/10/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured02/10/2023
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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