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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 10/27/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that on (b)(6) 2025, a 8-6mm amplatzer pda occluder was chosen for implant using an abbott delivery system.During the procedure, it was observed that the arota disc of the pda occluder did not open well.The device took form of a cobra deformation.The deformed device was never released from the delivery cable.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 another 8-6mm amplatzer pda occluder.The patient remained hemodynamically stable throughout the procedure.There was no clinically significant delay in procedure and no adverse patient effects.
 
Additional Manufacturer Narrative
Investigation is not yet complete.A follow-up report will be submitted with all additional relevant information.
 
Event or Problem Description
N/a.
 
Additional Manufacturer Narrative
An event of device deformity was reported.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.There were no complaints associated with any other devices from the lot.Based on the information received, 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 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 Key23623933
Report Number2135147-2025-06868
Device Sequence Number15955361
Product Code MAE
UDI-Device Identifier00811806011127
UDI-Public(01)00811806011127(17)300131(10)10716983
Combination Product (Y/N)N
Initial Reporter CountryKS
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) 01/06/2026
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 Number10716983
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/12/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/27/2025
Supplement Date Received by Manufacturer12/15/2025
Initial Report FDA Received Date11/21/2025
Supplement Report FDA Received Date01/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/11/2025
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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