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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL AMPLATZER PFO OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER

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ABBOTT MEDICAL AMPLATZER PFO OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER Back to Search Results
Model Number 9-PFO-035
Medical Device Problem Code Difficult to Fold, Unfold or Collapse (1254)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/30/2025
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) 2025, a 35mm amplatzer pfo occluder was chosen for procedure using a 9f amplatzer torqvue delivery system.During the deployment, an abnormal expansion was observed at the waist of the device.The deformed device was never released from the delivery cable while inside the patient.There was report of any interaction with cardiac structures during deployment.There was no report of any angulation/kink noticed with the delivery system.A new 35mm amplatzer pfo occluder was chosen and completed the procedure.The patient remained hemodynamically stable throughout the procedure.There was no clinically significant delay in procedure and no adverse patient effects.The operation was successful and the patient was reported healthy.
 
Additional Manufacturer Narrative
An event of device deformity could not be confirmed.The device was returned to abbott for investigation and the device met functional specifications when analyzed under non-physiological conditions.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed, and the product met all defined manufacturing specifications.Additionally, the lot was reviewed for similar complaints, and there is no indication of a lot-specific product issue.The cause of the reported incident 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
AMPLATZER PFO OCCLUDER
Common Device Name
TRANSCATHETER SEPTAL OCCLUDER
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT MEDICAL REG# 2135147
5050 nathan ln n
plymouth MN 55442
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key22865897
Report Number2135147-2025-04692
Device Sequence Number18055001
Product Code MLV
UDI-Device Identifier00811806011301
UDI-Public(01)00811806011301(17)290731(10)10492479
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
P120021
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) 11/12/2025
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 Number9-PFO-035
Device Catalogue Number9-PFO-035
Device Lot Number10492479
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/18/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/30/2025
Supplement Date Received by Manufacturer11/05/2025
Initial Report FDA Received Date08/21/2025
Supplement Report FDA Received Date11/12/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/29/2024
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
Concomitant Medical Products
and Therapy/Usage Dates
9F AMPLATZER TORQVUE DELIVERY SYSTEM, 9-ITV09F45/8.
Patient Age40 YR
Patient SexFemale
Patient Weight55 KG
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