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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL AMPLATZER SEPTAL OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER

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ABBOTT MEDICAL AMPLATZER SEPTAL OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER Back to Search Results
Catalog Number 9-ASD-016
Medical Device Problem Code Difficult to Fold, Unfold or Collapse (1254)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/26/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that on (b)(6) 2024, a 16mm amplatzer septal occluder was selected for implant using a 8f treviso delivery system (ds).During the procedure, while the device was being deployed, the device presented in a cobra deformation.The device wasn't implanted and a 26mm amplatzer septal occluder was implanted using a 10f treviso ds.The larger size allowed the closure of two asds that were present.There was no angulation or kink noted in the delivery system or interactions with cardiac structures.The patient remained hemodynamically stable throughout the procedure and there was no clinically significant delay.
 
Additional Manufacturer Narrative
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 16mm amplatzer septal occluder was selected for implant using a 8f treviso delivery system (ds).During the procedure, while the device was being deployed, the device presented in a cobra deformation.The device wasn't implanted and a 26mm amplatzer septal occluder was implanted using a 10f treviso ds.The larger size allowed the closure of two asds that were present.There was no angulation or kink noted in the delivery system or interactions with cardiac structures.The patient remained hemodynamically stable throughout the procedure and there was no clinically significant delay.
 
Additional Manufacturer Narrative
An event of device deformity was reported.The device was returned to abbott for investigation and the device met functional specifications when analyzed under non-physiological conditions.Information from the field indicated that there was no angulation or kink noted in the delivery system or interactions with cardiac structures.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed and the product met all defined manufacturing specifications.Please note that per the instructions for use, the recommended size delivery system for use with a 16 mm septal occluder is an 7f.A 8f sheath was used to deliver the device.There were no complaints associated with any other devices from the lot.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
AMPLATZER SEPTAL OCCLUDER
Common Device Name
TRANSCATHETER SEPTAL OCCLUDER
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 Key20257065
Report Number2135147-2024-04599
Device Sequence Number8014161
Product Code MLV
UDI-Device Identifier00811806010137
UDI-Public(01)00811806010137(17)280831(10)10003442
Combination Product (Y/N)N
Initial Reporter CountryAS
PMA/510(K) Number
P000039
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) 10/24/2024
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 Number9-ASD-016
Device Lot Number10003442
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 08/26/2024
Supplement Date Received by Manufacturer10/14/2024
Initial Report FDA Received Date09/19/2024
Supplement Report FDA Received Date10/24/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/26/2023
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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