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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL MITRACLIP G4 CLIP DELIVERY SYSTEM (MDD); MITRAL VALVE REPAIR DEVICES

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ABBOTT MEDICAL MITRACLIP G4 CLIP DELIVERY SYSTEM (MDD); MITRAL VALVE REPAIR DEVICES Back to Search Results
Catalog Number CDS0702-XTW
Device Problem Difficult to Open or Close (2921)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/02/2024
Event Type  malfunction  
Manufacturer Narrative
The device has been received.However, investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Event Description
It was reported this was a mitraclip procedure to treat mixed mitral regurgitation (mr) with a grade of 4, flail, and prolapsed leaflets.An xtw clip was prepared per the instructions for use (ifu) and inserted without issues.It was noted after a few grasping attempts, it was observed that one gripper was not functioning as intended.Therefore, the clip was removed and replaced.Three clips were then deployed, reducing mr to a grade of 2.There were no adverse patient effects and no clinically significant delay in the procedure.
 
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Brand Name
MITRACLIP G4 CLIP DELIVERY SYSTEM (MDD)
Type of Device
MITRAL VALVE REPAIR DEVICES
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT VASCULAR, REG # 3005070406
3885 bohannon drive
menlo park CA 94025
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key19181602
MDR Text Key341125668
Report Number2135147-2024-01834
Device Sequence Number1
Product Code NKM
UDI-Device Identifier08717648231018
UDI-Public(01)08717648231018(17)241029(10)31031R1009
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
P100009
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 04/25/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/25/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberCDS0702-XTW
Device Lot Number31031R1009
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/15/2024
Is the Reporter a Health Professional? Yes
Date Manufacturer Received04/02/2024
Was Device Evaluated by Manufacturer? No
Date Device Manufactured10/31/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Treatment
STEERABLE GUIDE CATHETER
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