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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BAYLIS MEDICAL COMPANY INC. NRG TRANSSEPTAL NEEDLE; CATHETER, SEPTOSTOMY

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BAYLIS MEDICAL COMPANY INC. NRG TRANSSEPTAL NEEDLE; CATHETER, SEPTOSTOMY Back to Search Results
Model Number NRG-E-HF-71-C0
Medical Device Problem Code Failure to Advance (2524)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/29/2023
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a septal puncture procedure an nrg transseptal needle was selected for use.Energization of the needle was able to be performed with no problems; however, the septal puncture could not be performed.Energization was performed three times thereafter, but the approach was still not possible.It was noted that the tip of the needle felt stiffer than usual as well.The needle was replaced with another of the same model.The procedure was completed with no patient complications.
 
Additional Manufacturer Narrative
E1: initial reporter phone: (b)(6).The device has not been received for analysis.Upon receipt and completion of the failure analysis of the complaint device, if there is any further relevant information from that review, a supplemental medwatch will be filed.
 
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Brand Name
NRG TRANSSEPTAL NEEDLE
Common Device Name
CATHETER, SEPTOSTOMY
Manufacturer (Section D)
BAYLIS MEDICAL COMPANY INC.
5959 trans-canada highway
montreal qc H4T 1 A1
CA  H4T 1A1
Manufacturer (Section G)
BAYLIS MEDICAL COMPANY INC.
5825 explorer drive
mississauga on L4W 5 P6
CA   L4W 5P6
Manufacturer Contact
timothy degroot
4100 hamline avenue north
dc a330
saint paul, MN 55112
6515826168
MDR Report Key16825684
Report Number2124215-2023-16111
Device Sequence Number6735645
Product Code DXF
UDI-Device Identifier00685447000204
UDI-Public00685447000204
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K073326
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 04/27/2023
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? Yes
Operator of Device Health Professional
Device Expiration Date12/22/2024
Device Model NumberNRG-E-HF-71-C0
Device Lot NumberNGFE161221
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/31/2023
Initial Report FDA Received Date04/27/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured01/20/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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