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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL REGENT HEART VALVE WITH FLEX CUFF; HEART-VALVE, MECHANICAL

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ABBOTT MEDICAL REGENT HEART VALVE WITH FLEX CUFF; HEART-VALVE, MECHANICAL Back to Search Results
Catalog Number 21AGFN-756
Medical Device Problem Code Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/28/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device will not be returned for evaluation, the device was reportedly discarded.Investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Event or Problem Description
It was reported that on (b)(6) 2024, a 21mm sjm regent heart valve w/ flex cuff was chosen for a procedure.The valve was implanted.When the physician tried to rotate the valve, the valve was not able to be rotated, resistance was felt.The valve was replaced with new 21mm sjm regent heart valve w/ flex cuff valve.The replacement valve was successfully implanted.There was no delay and no adverse health consequences to the patient occurred.
 
Additional Manufacturer Narrative
An event of valve was not able to be rotate was reported.A more comprehensive assessment, including hydrodynamic testing to evaluate valve function could not be performed as the device 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.Based on the information received, the cause of the reported incident could not be conclusively determined.There is no indication of a product quality issue with respect to labeling design or manufacturing of the device.
 
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Brand Name
REGENT HEART VALVE WITH FLEX CUFF
Common Device Name
HEART-VALVE, MECHANICAL
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ST. JUDE MEDICAL PUERTO RICO, INC. REG#2648612
20 b st caguas west park
caguas 00725
*   00725
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key19020231
Report Number2135147-2024-01474
Device Sequence Number12747535
Product Code LWQ
UDI-Device Identifier05414734005975
UDI-Public(01)05414734005975(17)280223(10)C00009203
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
P810002
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Device Explanted Year2024
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 04/18/2024
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
Operator of Device Health Professional
Device Catalogue Number21AGFN-756
Device Lot NumberC00009203
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 03/08/2024
Supplement Date Received by Manufacturer04/17/2024
Initial Report FDA Received Date04/02/2024
Supplement Report FDA Received Date04/18/2024
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured02/24/2023
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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