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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ST. JUDE MEDICAL FAST-CATH¿ TRANSSEPTAL GUIDING INTRODUCER SWARTZ¿ SL TRANSSEPTAL SERIES, SL3¿ 8F; Introducer, catheter

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ST. JUDE MEDICAL FAST-CATH¿ TRANSSEPTAL GUIDING INTRODUCER SWARTZ¿ SL TRANSSEPTAL SERIES, SL3¿ 8F; Introducer, catheter Back to Search Results
Model Number 406842
Medical Device Problem Code Fluid/Blood Leak (1250)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/05/2025
Type of Reportable Event Malfunction
Event or Problem Description
During the atrial fibrillation procedure, blood leaked from the hemostasis valve when applying negative pressure.The introducer was replaced and the procedure was completed with no adverse consequences to the patient.No air movement into the patient was confirmed.No additional puncture was performed when the introducer was replaced.
 
Additional Manufacturer Narrative
The results of the investigation are inconclusive since the device was not returned for analysis.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed.Based on the information received, the cause of the reported incident could not be conclusively determined.
 
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Brand Name
FAST-CATH¿ TRANSSEPTAL GUIDING INTRODUCER SWARTZ¿ SL TRANSSEPTAL SERIES, SL3¿ 8F
Common Device Name
Introducer, catheter
Manufacturer (Section D)
ST. JUDE MEDICAL
5050 nathan lane north
plymouth MN 55442
Manufacturer (Section G)
ST. JUDE MEDICAL
5050 nathan lane north
plymouth MN 55442
Manufacturer Contact
wendy mccarty
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key21472284
Report Number3005334138-2025-00121
Device Sequence Number11615455
Product Code DYB
UDI-Device Identifier05414734203364
UDI-Public(01)05414734203364(10)8530394(17)250531
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K964518
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) 02/26/2025
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 Expiration Date05/31/2025
Device Model Number406842
Device Catalogue Number406842
Device Lot Number8530394
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 02/19/2025
Initial Report FDA Received Date02/26/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured06/20/2022
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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