It was reported that on(b)(6)2024, a patient presented with grade 4 mixed mitral regurgitation (mr) and an enlarged left atrium for a mitraclip procedure.Two mitraclips were implanted and the mr was reduced to grade 1+.On (b)(6)2024, a single leaflet device attachment (slda) was observed with the second clip.The posterior leaflet was detached from the clip and a leaflet tear was noted.The mr increased from grade 1+ to grade 2-3.The physician did not comment on why the slda occurred.
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The device was not returned for analysis.A review of the lot history record revealed no manufacturing nonconformities issued to the reported lot that would have contributed to this event.Additionally, a review of the complaint history identified no similar complaints reported from this lot.Based on available information, the cause of the reported slda and tissue injury were unable to be determined.The reported recurrent mr was a cascading event of the reported slda.The reported patient effects of mitral regurgitation and tissue injury, as listed in the mitraclip system instructions for use, are known possible complications associated with mitraclip procedures.The reported serious injury/ illness/ impairment was a result of case-specific circumstances.There is no indication of a product quality issue with respect to manufacture, design, or labeling.
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