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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL MASTERS SERIES EXPANDED HEMODYNAMIC PLUS VALVE; HEART-VALVE, MECHANICAL

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ABBOTT MEDICAL MASTERS SERIES EXPANDED HEMODYNAMIC PLUS VALVE; HEART-VALVE, MECHANICAL Back to Search Results
Catalog Number 25MHPJ-505
Medical Device Problem Code Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/18/2024
Type of Reportable Event Malfunction
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, 25mm sjm masters series hemodynamic plus valve was selected for implant.During the procedure, after the device had been implanted, it was noticed that the leaflets had issues opening and closing.It is unknown if there was any intervention.The patient remained hemodynamically stable throughout the procedure.There were no adverse patient effects and the patient is doing well.
 
Event or Problem Description
It was reported that on (b)(6) 2024, 25mm sjm masters series hemodynamic plus valve was selected for implant.During the procedure, after the device had been implanted, it was noticed that the leaflets had issues opening and closing.It is unknown if there was any intervention.The patient remained hemodynamically stable throughout the procedure.There were no adverse patient effects and the patient is doing well.
 
Additional Manufacturer Narrative
An event of leaflets not opening and closing smoothly was reported.The device was returned to abbott for investigation.No anomalies were found with the valve leaflets with both leaflets able to fully open and close without resistance.Hydrodynamic examination indicated the valve met functional specification.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed, including functional testing, and the product met all specifications.The cause of the reported event 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
MASTERS SERIES EXPANDED HEMODYNAMIC PLUS VALVE
Common Device Name
HEART-VALVE, MECHANICAL
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT MEDICAL REG# 2648612
lot 20 b st caguas
caguas 00725
*   00725
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key20929414
Report Number2135147-2024-06383
Device Sequence Number15532315
Product Code LWQ
UDI-Device Identifier05415067043771
UDI-Public(01)05415067043771(17)281018(10)C00016442
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
P810002
Number of Events Summarized1
Summary Report (Y/N)N
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) 02/03/2025
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
Operator of Device Health Professional
Device Catalogue Number25MHPJ-505
Device Lot NumberC00016442
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/06/2024
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/20/2024
Supplement Date Received by Manufacturer01/17/2025
Initial Report FDA Received Date12/13/2024
Supplement Report FDA Received Date02/03/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/20/2023
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 Age51 YR
Patient SexFemale
Patient Weight56 KG
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