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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 Material Separation (1562)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/29/2024
Event Type  malfunction  
Event Description
It was reported that during device preparation, the clip delivery system (cds) opened from its packaging (first clip to be used in the case).No damage was evident on the packaging.Upon opening the packaging, a screw was loose in the plastic packaging.The screw was loose from the dc handle, the second from the left under the gripper lever.No preparation steps took place prior to this.The cds was therefore immediately deemed faulty and was not used.A new cds was immediately opened and prepared.There was no significant time delay and the rest of the case was completed without issue.
 
Manufacturer Narrative
Investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Manufacturer Narrative
All available information was investigated, and the reported loose dc handle screw was 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.Based on available information and the returned device analysis, the investigation determined the loose dc handle screw to be related to a potential product quality issue.This complaint is within the scope of an exception escalation as the complaint description and device code match the specific issue described in the exception.Therefore, this incident was added to exception (issue) 130612 for further investigation.The issue is being addressed per internal operating procedures.Abbott will continue to trend the performance of these devices.
 
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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 Key18952634
MDR Text Key338432198
Report Number2135147-2024-01300
Device Sequence Number1
Product Code NKM
UDI-Device Identifier08717648231018
UDI-Public(01)08717648231018(17)241029(10)31031R1030
Combination Product (y/n)N
Reporter Country CodeUK
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,Followup
Report Date 04/11/2024
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 NumberCDS0702-XTW
Device Lot Number31031R1030
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Initial Date Manufacturer Received 02/29/2024
Initial Date FDA Received03/21/2024
Supplement Dates Manufacturer Received03/27/2024
Supplement Dates FDA Received04/11/2024
Was Device Evaluated by Manufacturer? Yes
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
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