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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ZOLL CIRCULATION, INC. QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE HEPARIN E; INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER

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ZOLL CIRCULATION, INC. QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE HEPARIN E; INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER Back to Search Results
Model Number IC-4593AE
Medical Device Problem Code Difficult to Insert (1316)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/12/2024
Type of Reportable Event Malfunction
Event or Problem Description
During multiple attempts, the customer had difficulty removing the guidewire from the quattro catheter.Three quattro catheters and zoll guidewires were attempted to insert into the femoral vein (right and left sides).Each attempt was difficult and required multiple insertions.The customer reported that the guidewire could not be removed from any of the three catheters, and the catheter had to be removed along with the guidewire each time.Per the customer, the physician's experience with intravascular catheter placement was frequent, and per the physician, there was no increased tortuosity in the vein.No patient injury was reported.The customer saved only one catheter (lot #198059) with guidewire (lot #199681) for investigation.The lot numbers of the two other catheters and the guidewires are unknown, and the customer has disposed of them.
 
Additional Manufacturer Narrative
Zoll has not received the quattro catheter for investigation.A follow-up report will be submitted if and when the product is returned, and the investigation has been completed.
 
Additional Manufacturer Narrative
The catheter involved in the reported complaint will not be returned for investigation because the customer has disposed of it.Therefore, a physical investigation could not be performed, and the root cause could not be determined.
 
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Brand Name
QUATTRO® INTRAVASCULAR HEAT EXCHANGE CATHETER KIT CUSTOM LUER APPLAUSE HEPARIN E
Common Device Name
INTRAVASCULAR CORE TEMPERATURE REGULATION SYSTEM CATHETER
Manufacturer (Section D)
ZOLL CIRCULATION, INC.
2000 ringwood ave.
san jose CA 95131
Manufacturer (Section G)
ZOLL CIRCULATION, INC.
2000 ringwood ave.
san jose CA 95131
Manufacturer Contact
kimthoa sackrison
2000 ringwood ave.
san jose, CA 95131
4084192347
MDR Report Key20860871
Report Number3010617000-2024-00952
Device Sequence Number8585411
Product Code NCX
UDI-Device Identifier00849111075275
UDI-Public00849111075275
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K101987
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 01/02/2025
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
Device Model NumberIC-4593AE
Device Catalogue Number8700-0783-40
Device Lot Number198059
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/13/2024
Supplement Date Received by Manufacturer01/02/2025
Initial Report FDA Received Date12/06/2024
Supplement Report FDA Received Date01/02/2025
Was Device Evaluated by Manufacturer? (Y/N) No
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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