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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-006
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 10/08/2025
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 10-8 mm amplatzer pda duct occluder was chosen for implant using a non-abbott delivery system.During the procedure, while deploying the physician noted that the device was not conforming to its intended shape and the occluder took form of a cobra head.Therefore, the physician had to retrieve the deformed device back.The deformed device was never released from the delivery cable while inside the patient.There were no angulation or kink noticed in the delivery system.The patient remained hemodynamically stable throughout the procedure.There was no clinically significant delay in procedure and no adverse patient effects.
 
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 specifications.The cause of the reported incident could not be conclusively determined.There were no complaints associated with any other devices from the lot.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 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 Key23442105
Report Number2135147-2025-06306
Device Sequence Number4782910
Product Code MAE
UDI-Device Identifier00811806011134
UDI-Public(01)00811806011134(17)300131(10)10709708
Combination Product (Y/N)N
Initial Reporter CountryIN
PMA/510(K) Number
P020024
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) 12/24/2025
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-006
Device Catalogue Number9-PDA-006
Device Lot Number10709708
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 10/08/2025
Supplement Date Received by Manufacturer12/19/2025
Initial Report FDA Received Date10/31/2025
Supplement Report FDA Received Date12/24/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/05/2025
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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