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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BOSTON SCIENTIFIC CORPORATION METRIQ IRRIGATION TUBING SET; CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER

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BOSTON SCIENTIFIC CORPORATION METRIQ IRRIGATION TUBING SET; CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER Back to Search Results
Model Number M0041170
Medical Device Problem Code Defective Device (2588)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/27/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that visible air was seen in the tubing past the pump.A metriq tubing set was used to treat atrial fibrillation during an ablation procedure.When the ablation catheter was connected, flushing was performed; however, the bubbles could not be removed.Additionally, visible air was seen in the tubing past the pump.The device was replaced, and the procedure was completed successfully with no patient complications.The device was discarded and will not be returned for analysis.
 
Additional Manufacturer Narrative
It was indicated that the device will not be returned for evaluation.If there is any further relevant information obtained, a supplemental medwatch will be filed.
 
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Brand Name
METRIQ IRRIGATION TUBING SET
Common Device Name
CATHETER, PERCUTANEOUS, CARDIAC ABLATION, FOR TREATMENT OF ATRIAL FLUTTER
Manufacturer (Section D)
BOSTON SCIENTIFIC CORPORATION
300 boston scientific way
marlborough MA 01752
Manufacturer (Section G)
AVAIL MEDICAL PRODUCTS INCORPORATED
6201 america center drive
san jose CA 95002
Manufacturer Contact
mary crawford
4100 hamline avenue north
dc a330
saint paul, MN 55112
6514400979
MDR Report Key22461467
Report Number2124215-2025-44103
Device Sequence Number20847561
Product Code OAD
UDI-Device Identifier08714729862208
UDI-Public(01)08714729862208(17)250624(10)60570559
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
P150005
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 07/09/2025
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 Date06/24/2025
Device Model NumberM0041170
Device Catalogue NumberM0041170
Device Lot Number0060570559
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 06/10/2025
Initial Report FDA Received Date07/09/2025
Date Device Manufactured06/24/2024
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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