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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL AMPLATZER DUCT OCCLUDER; OCCLUDER, PATENT DUCTUS, ARTERIOSUS

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ABBOTT MEDICAL AMPLATZER DUCT OCCLUDER; OCCLUDER, PATENT DUCTUS, ARTERIOSUS Back to Search Results
Model Number 9-PDA-005
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 08/27/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device is not returning for evaluation.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 8-6mm amplatzer duct occluder was chosen for implant using a 7f amplatzer torqvue delivery system.During the procedure, the occluder took form of a cobra deformation.The deformed device was never released from the delivery cable while inside the patient.It is noted that there was no interaction with the cardiac structures during deployment and no angulation/kink were noticed in the delivery system.The procedure was completed using a non-abbott device.There was no clinically significant delay and the patient remained hemodynamically stable with no adverse consequences.
 
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.No anatomical interference, or angulation or kink in the delivery system was reported.The device history record was reviewed to ensure that each manufacturing and inspection operation was performed and the product met all specifications.The image had shown small deformation on the lobe of the occluder.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.
 
Event or Problem Description
N/a.
 
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Brand Name
AMPLATZER DUCT OCCLUDER
Common Device Name
OCCLUDER, PATENT DUCTUS, ARTERIOSUS
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 Key23100968
Report Number2135147-2025-05337
Device Sequence Number8572852
Product Code MAE
UDI-Device Identifier00811806011127
UDI-Public(01)00811806011127(17)271231(10)8857575
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
P020024
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2025
Device Explanted Year2025
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) 10/21/2025
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-PDA-005
Device Catalogue Number9-PDA-005
Device Lot Number8857575
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/27/2025
Supplement Date Received by Manufacturer10/06/2025
Initial Report FDA Received Date09/19/2025
Supplement Report FDA Received Date10/21/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/25/2023
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
TORQVUE DS(PART: 9-ITV07F180/80, LOT:8745263).
Patient SexUnknown
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