• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

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

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

ABBOTT MEDICAL MITRACLIP G4 CLIP DELIVERY SYSTEM (MDR); MITRAL VALVE REPAIR DEVICES Back to Search Results
Catalog Number CDS0706-XTW
Device Problems Deformation Due to Compressive Stress (2889); Difficult to Open or Close (2921)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/27/2024
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 degenerative mitral regurgitation (mr) with a grade of 4.An xtw clip was inserted and advanced under the mitral valve.However, while actuating independent grippers, the anterior gripper would not lower.Troubleshooting was performed, including the grippers cycled and the lock line tested, but the issue was unable to be resolved.Therefore, the clip was removed and replaced.While outside the anatomy, a kink was observed to be on the lock line or gripper line.The procedure was continued, and a new xtw clip was successfully implanted, reducing mr to a grade of 1.There were no adverse patient effects and no clinically significant delay in the procedure.
 
Manufacturer Narrative
All available information was investigated and the reported gripper actuation issue and kinked gripper/lock line were not confirmed via returned 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 complaints reported from this lot.The investigation was unable to determine a cause for the reported gripper actuation issue and kinked line.There is no indication of a product issue with respect to manufacture, design, or labeling.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
MITRACLIP G4 CLIP DELIVERY SYSTEM (MDR)
Type of Device
MITRAL VALVE REPAIR DEVICES
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT MEDICAL NORTHPOINT REG 3020950818
1820 bastian court
westfield IN 46074
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key18926681
MDR Text Key337944555
Report Number2135147-2024-01222
Device Sequence Number1
Product Code NKM
UDI-Device Identifier05415067037381
UDI-Public(01)05415067037381(17)241025(10)31026A2052
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P100009
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 04/12/2024
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 Catalogue NumberCDS0706-XTW
Device Lot Number31026A2052
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/11/2024
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/27/2024
Initial Date FDA Received03/18/2024
Supplement Dates Manufacturer Received03/26/2024
Supplement Dates FDA Received04/12/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured10/27/2023
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.
Patient Age69 YR
Patient SexFemale
-
-