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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: INTEGRA LIFESCIENCES MANSFIELD MICROSENSOR VENTRICULAR CATHETER KIT; ICP MICROSENSORS (ROHS)

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INTEGRA LIFESCIENCES MANSFIELD MICROSENSOR VENTRICULAR CATHETER KIT; ICP MICROSENSORS (ROHS) Back to Search Results
Catalog Number 826653
Medical Device Problem Code Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/06/2024
Type of Reportable Event Serious Injury
Event or Problem Description
A facility reported a microsensor (id 826653) was implanted.One hour after the procedure, the microsensor was leaking csf from the catheter.Then, the physician used adhesive plasters to wrap the microsensor while there was still csf leaking from the catheter.Therefore, the sensor was retrieved it on (b)(6) 2024.Patient status was reported as stable.
 
Additional Manufacturer Narrative
An investigation has been initiated based on the reported information.Upon completion of the investigation, a follow-up report will be submitted.
 
Additional Manufacturer Narrative
Updated fields: d4, d8, d9, e1, g2, g3, g6, h2, h3, h4, h6, h11 the microsensor catheter kit (b)(6) was returned for evaluation.Device history record (dhr) - the batch record was reviewed for any anomalies or non-conformances related to the finished device, and none were identified, related to this report.Failure analysis - a visual inspection was conducted.No defects or damage were found.A syringe with water was connected to the catheter.Water was injected to observe any areas of leakage.No leaks were found.The complaint was not confirmed.Root cause analysis - the complaint was not confirmed during investigation.The potential root causes surgeon applies sutures/ligatures too tight perforating catheter.
 
Event or Problem Description
N/a.
 
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Brand Name
MICROSENSOR VENTRICULAR CATHETER KIT
Common Device Name
ICP MICROSENSORS (ROHS)
Manufacturer (Section D)
INTEGRA LIFESCIENCES MANSFIELD
11 cabot boulevard
11 cabot boulevard
mansfield MA 02048
Manufacturer (Section G)
INTEGRA LIFESCIENCES MANSFIELD
11 cabot boulevard
mansfield MA 02048
Manufacturer Contact
vivian nelson
1100 campus drive
princeton, NJ 08540
6099362319
MDR Report Key20086832
Report Number3014334038-2024-00181
Device Sequence Number15406504
Product Code GWM
UDI-Device Identifier10381780520566
UDI-Public10381780520566
Combination Product (Y/N)N
PMA/510(K) Number
K991222
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
Device Explanted Year2024
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,User Facility
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 09/05/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue Number826653
Device Lot Number7058605
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/12/2024
Supplement Date Received by Manufacturer08/14/2025
Initial Report FDA Received Date08/28/2024
Supplement Report FDA Received Date09/05/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/01/2023
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 Unknown
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
CABLE (ID (B)(6)).; MONITOR (ID (B)(6)).
Outcome Attributed to Adverse Event Required Intervention;
Patient Age74 YR
Patient SexMale
Patient EthnicityNon Hispanic
Patient RaceAsian
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