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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: EDWARDS LIFESCIENCES, PR SWAN-GANZ CCOMBO V; CATHETER, FLOW DIRECTED

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EDWARDS LIFESCIENCES, PR SWAN-GANZ CCOMBO V; CATHETER, FLOW DIRECTED Back to Search Results
Model Number 777F8
Medical Device Problem Code Incorrect, Inadequate or Imprecise Result or Readings (1535)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/25/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during use of this swan-ganz catheter, the numbers were suspected of being inaccurate.The device was zeroed correctly.The suspect device was switched out for a new one and everything worked as expected.There was no patient injury.
 
Additional Manufacturer Narrative
The device is anticipated to be returned for evaluation but has not yet been received.A supplemental report will be forthcoming when the investigation is completed, as well as the device history record review results.Additional product codes: kra - catheter continuous flush dqe - catheter, oximeter, fiberoptic.Dqo - catheter, intravascular, diagnostic.
 
Additional Manufacturer Narrative
The device was not be returned for evaluation.Without the return of the unit, it is not possible to determine if some damage or defect existed on the unit that could have contributed to the event.It is not known if some procedural factors may have contributed to the event.A device history record review was completed and documented that the device met all specifications upon distribution.Complaint histories for all reported events are reviewed against trending control limits on a monthly basis, and any excursions above the control limits are assessed and documented as part of this monthly review.
 
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Brand Name
SWAN-GANZ CCOMBO V
Common Device Name
CATHETER, FLOW DIRECTED
Manufacturer (Section D)
EDWARDS LIFESCIENCES, PR
state rd indus pk 402 km 1.4
anasco PR 00610
Manufacturer (Section G)
EDWARDS LIFESCIENCES, PR
state rd indus pk 402 km 1.4
anasco PR 00610
Manufacturer Contact
samantha eveleigh
17200 laguna canyon rd
irvine, CA 92618
9492017706
MDR Report Key23080046
Report Number2015691-2025-07667
Device Sequence Number15887337
Product Code DYG
UDI-Device Identifier00690103146554
UDI-Public(01)00690103146554(17)260905(11)240905(10)65977956
Combination Product (Y/N)N
Initial Reporter StateIL
Initial Reporter CountryUS
PMA/510(K) Number
PREAMEND
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 11/03/2025
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 Expiration Date09/05/2026
Device Model Number777F8
Device Lot Number65977956
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 08/27/2025
Supplement Date Received by Manufacturer10/31/2025
Initial Report FDA Received Date09/17/2025
Supplement Report FDA Received Date11/03/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured09/05/2024
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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