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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL AMPLATZER SEPTAL OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER

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ABBOTT MEDICAL AMPLATZER SEPTAL OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER Back to Search Results
Catalog Number 9-ASD-015
Device Problem Patient Device Interaction Problem (4001)
Patient Problems Fatigue (1849); Headache (1880); Movement Disorder (4412)
Event Date 01/18/2024
Event Type  malfunction  
Event Description
The article, "headaches in children after transcatheter device closure of atrial septal defects: a single centre experience", was reviewed.The article presented a case study of a 5-year-old, 16.5 kg, female patient with a fenestrated atrial septal defect.It was reported that on an unknown date, a 15mm amplatzer septal occluder was implanted.A small residual shunt was noted during procedure.It was then reported shortly after procedure, the patient developed dizziness and fatigue.Magnetic resonance imaging (mri) was performed, however, results were normal and non-pathologic.The patient later described experiencing headaches, gradually improving but still documented several years after the procedure.The article concluded that the study suggested a minimal estimate of 15% as the incidence of headache in children who undergo tdc.This estimate can inform counseling prior to tdc.Determination of the true incidence will require focused prospective data collection.[(b)(6)].
 
Manufacturer Narrative
Investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Manufacturer Narrative
As reported in a research article, "headaches in children after transcatheter device closure of atrial septal defects: a single centre experience", on an unknown date, a 15mm amplatzer septal occluder was implanted in a 5-year-old, 16.5 kg, female patient with a fenestrated atrial septal defect.A more comprehensive assessment could not be performed as the event was non-contemporaneously reported through a literature review and no device was received for analysis.Peri- and post-procedural complications included dizziness (movement disorder), fatigue, headaches, residual shunt.Based on the information received, the cause of the reported incident could not be conclusively determined.
 
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Brand Name
AMPLATZER SEPTAL OCCLUDER
Type of Device
TRANSCATHETER SEPTAL OCCLUDER
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT MEDICAL REG# 2135147
5050 nathan ln n
plymouth MN 55442
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key18748644
MDR Text Key336750105
Report Number2135147-2024-00787
Device Sequence Number1
Product Code MLV
UDI-Device Identifier00811806010120
UDI-Public00811806010120
Combination Product (y/n)N
Reporter Country CodeCA
PMA/PMN Number
P000039
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Literature
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 03/06/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/21/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number9-ASD-015
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received02/21/2024
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Other;
Patient Age5 YR
Patient SexFemale
Patient Weight17 KG
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