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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL, INC. ENSITE¿ X DISPLAY WORKSTATION; Computer, diagnostic, programmable

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ST. JUDE MEDICAL, INC. ENSITE¿ X DISPLAY WORKSTATION; Computer, diagnostic, programmable Back to Search Results
Model Number ENSITE-DWS-2.0.1
Medical Device Problem Code Communication or Transmission Problem (2896)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/20/2025
Type of Reportable Event Malfunction
Event or Problem Description
During an atrial tachycardia procedure, communication issues resulted in a procedural delay.While working in voxel mode, the ablation catheter was no longer displayed.All the cables were check and reconnected.The catheter was replaced with no resolution.The dws was restarted and the study was resumed which resolved the issue.The procedure was successfully completed with no adverse consequences to the patient.
 
Additional Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.Based on the information received, the cause of the reported incident could not be determined.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed.No non-conformances associated with the reported event were identified.
 
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Brand Name
ENSITE¿ X DISPLAY WORKSTATION
Common Device Name
Computer, diagnostic, programmable
Manufacturer (Section D)
ST. JUDE MEDICAL, INC.
one st. jude medical drive
st. paul MN 55117
Manufacturer (Section G)
ST. JUDE MEDICAL, INC.
one st. jude medical drive
st. paul MN 55117
Manufacturer Contact
wendy mccarty
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key21217400
Report Number2184149-2025-00020
Device Sequence Number18328127
Product Code DQK
UDI-Device Identifier05415067046710
UDI-Public(01)05415067046710(10)10330746
Combination Product (Y/N)N
Initial Reporter CountryGM
PMA/510(K) Number
K231415
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 01/23/2025
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 Model NumberENSITE-DWS-2.0.1
Device Catalogue NumberENSITE-DWS-2.0.1
Device Lot Number10330746
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Was the Report Sent to FDA? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/20/2025
Initial Report FDA Received Date01/23/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/07/2024
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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