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U.S. Department of Health and Human Services

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

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ABBOTT MEDICAL MITRACLIP G4 CLIP DELIVERY SYSTEM; MITRAL VALVE REPAIR DEVICES Back to Search Results
Catalog Number CDS0702-NTW
Device Problem Tear, Rip or Hole in Device Packaging (2385)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/31/2022
Event Type  malfunction  
Manufacturer Narrative
The device is expected to be returned for investigation.It has not yet been received.A follow-up report will be submitted with all additional relevant information.
 
Event Description
This is filed to report a hole in the device packaging with unknown sterility.It was reported that a mitraclip device that was delivered had a hole in the shipping packing and the inner packaging.It is unknown if the sterility of the device was intact.There was no patient involvement.No additional information was provided.
 
Manufacturer Narrative
All available information was investigated, and the reported tear, rip or hole in device packaging was confirmed via device 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 incidents reported from this lot.Based on available information, the cause of the reported hole in the device packaging could not be determined.There is no indication of a product quality issue with respect to manufacture, design, or labeling.
 
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Brand Name
MITRACLIP G4 CLIP DELIVERY SYSTEM
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 Key15852443
MDR Text Key305635267
Report Number2135147-2022-02197
Device Sequence Number1
Product Code NKM
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
P100009
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional
Reporter Occupation Pharmacist
Type of Report Initial,Followup
Report Date 12/22/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date08/08/2023
Device Catalogue NumberCDS0702-NTW
Device Lot Number20809R1092
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 10/31/2022
Initial Date FDA Received11/23/2022
Supplement Dates Manufacturer Received12/01/2022
Supplement Dates FDA Received12/22/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured08/09/2022
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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