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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL PORTICO; AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIVERED

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ABBOTT MEDICAL PORTICO; AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIVERED Back to Search Results
Model Number PRT-29
Device Problem Central Regurgitation (4068)
Patient Problem Arrhythmia (1721)
Event Date 12/13/2021
Event Type  Injury  
Manufacturer Narrative
Investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Event Description
Crd_669 ¿ portico i, patient site id: (b)(4).It was reported that on (b)(6) 2016, a 29mm portico valve was implanted.There was good results post-implant with small para and transvalvular insufficiency.On (b)(6) 2021, echocardiogram was performed and revealed extrasystoles and only mild regurgitation.The patient was administered betablocker therapy.The patient is reported to be stable.It is believed that the extrasystoles are due to patient condition and not device performance.No additional information was provided.
 
Manufacturer Narrative
An event of extrasystoles and mild regurgitation was reported.A returned device assessment could not be performed as the device remains implanted and was not returned for analysis.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed and the product met all specifications.Information from the field indicated that the patient had baseline conduction abnormalities which included hypertension,hypertrophic cardiomyopathy and left bundle branch block.The field also indicated that it was believed that the reported event was caused by patient condition.Based on the information received the cause of the reported incident could not be conclusively determined but could have been as a result of patient conditions.There is no indication of a product quality issue with respect to labeling design or manufacturing of the device.Na.
 
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Brand Name
PORTICO
Type of Device
AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIVERED
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ST. JUDE MEDICAL #3014918977
edificio #44 calle 0, ave. 2
el coyol alajuela 1897- 4050
CS   1897-4050
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key15956395
MDR Text Key305242951
Report Number2135147-2022-02482
Device Sequence Number1
Product Code NPT
UDI-Device Identifier05415067012500
UDI-Public05415067012500
Combination Product (y/n)N
Reporter Country CodeGM
PMA/PMN Number
P190023
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Study,Health Professional,Company Representative
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 02/14/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/11/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Expiration Date07/19/2017
Device Model NumberPRT-29
Device Catalogue NumberPRT-29
Device Lot Number5595476
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received02/14/2023
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured07/19/2016
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
Patient Age78 YR
Patient SexMale
Patient Weight71 KG
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