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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL ADVISOR¿ FL, CIRCULAR MAPPING CATHETER, SENSOR ENABLED¿; CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING

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ST. JUDE MEDICAL ADVISOR¿ FL, CIRCULAR MAPPING CATHETER, SENSOR ENABLED¿; CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING Back to Search Results
Model Number D-AVSE-D10-F15
Device Problems Signal Artifact/Noise (1036); Expiration Date Error (2528)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/21/2023
Event Type  malfunction  
Event Description
Information received confirmed the device was expired when used.
 
Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed.Based on the information received, the cause of the reported noise remains unknown.Additional information received on 3/28/24 confirmed the correct lot number is 8622315 and the correct event date was october 21, 2023.The expiration date of this lot was january 31, 2024 and was therefore not expired at the time of use and is no longer a reportable event.
 
Event Description
Additional information received on 3/28/24 confirmed the correct lot number is 8622315 and the correct event date was october 21, 2023.The expiration date of this lot was january 31, 2024 and was therefore not expired at the time of use.
 
Manufacturer Narrative
One 15mm loop, uni-directional, curve d, sensor enabled, advisor fl circular mapping catheter was received for evaluation.Electrodes 1-2 met specifications for acceptable resistance values with no open or short circuits detected.This advisor fl circular mapping catheter batch number 8368219 expired on 31aug2023 which was prior to the reported event date of 23nov2023.A review of distribution records confirmed that this product was distributed prior to its expiration date.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed.The cause of the use of expired product is consistent with user error.
 
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Brand Name
ADVISOR¿ FL, CIRCULAR MAPPING CATHETER, SENSOR ENABLED¿
Type of Device
CATHETER, ELECTRODE RECORDING, OR PROBE, ELECTRODE RECORDING
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, COSTA RICA LTDA (AFD)
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 Key18778608
MDR Text Key336229520
Report Number3008452825-2024-00105
Device Sequence Number1
Product Code DRF
UDI-Device Identifier05415067024800
UDI-Public(01)05415067024800(10)8622315(17)240131
Combination Product (y/n)N
Reporter Country CodeCH
PMA/PMN Number
K160335, K20
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date 04/02/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/26/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date01/31/2024
Device Model NumberD-AVSE-D10-F15
Device Lot Number8622315
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Was the Report Sent to FDA? No
Date Manufacturer Received04/02/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured08/18/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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