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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL TRANSSEPTAL NEEDLE, BRK SERIES

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ST. JUDE MEDICAL TRANSSEPTAL NEEDLE, BRK SERIES Back to Search Results
Device Problem Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem Cardiac Perforation (2513)
Event Date 12/06/2022
Event Type  Injury  
Event Description
During an atrial fibrillation ablation procedure, a pericardial effusion developed following transseptal puncture and ablation with a non abbott catheter (j&j) in left pulmonary vein and cardioversion.The patient became hypotensive and an echocardiogram revealed a pericardial effusion.A pericardiocentesis and sternotomy were performed, and the patient was transferred to the icu in stable condition.Per the physician, the effusion was possibly the result of transseptal.There were no performance issues with any abbott devices.
 
Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.Review of the device history record was not possible as the lot number is unknown.Based on the information received, the cause of the reported pericardial effusion remains unknown.Per the ifu, cardiac perforation is a known risk during the use of this device.
 
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Brand Name
TRANSSEPTAL NEEDLE, BRK SERIES
Type of Device
TRANSSEPTAL NEEDLE
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
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 Key16022325
MDR Text Key305883071
Report Number3008452825-2022-00739
Device Sequence Number1
Product Code DRC
Combination Product (y/n)N
Reporter Country CodeAS
PMA/PMN Number
K072278
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,Followup
Report Date 01/11/2023
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? No
Device Operator Health Professional
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Initial Date Manufacturer Received 12/14/2022
Initial Date FDA Received12/21/2022
Supplement Dates Manufacturer Received01/05/2023
Supplement Dates FDA Received01/11/2023
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
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