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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL TRICLIP¿ STEERABLE GUIDE CATHETER; TRICUSPID VALVE REPAIR DEVICE, PERCUTANEOUSLY DELIVERED

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ABBOTT MEDICAL TRICLIP¿ STEERABLE GUIDE CATHETER; TRICUSPID VALVE REPAIR DEVICE, PERCUTANEOUSLY DELIVERED Back to Search Results
Model Number TSGC0201
Medical Device Problem Code Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/05/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device will not be returned for evaluation, the device was reportedly discarded.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 patient presented with grade 3-4 functional tricuspid regurgitation (tr) for a triclip procedure.During the preparation of steerable guide catheter(sgc), the guide was unable to hold column.A g5 sgc replacement was used to complete the procedure.The final tr was grade 1-2.There were no adverse patient effects or clinically significant delays reported.
 
Event or Problem Description
N/a.
 
Additional Manufacturer Narrative
The device was not returned for analysis.A review of the lot history record revealed no manufacturing nonconformities issued to the reported lot.Additionally, a review of the complaint history did not indicate a lot-specific quality issue.The investigation was unable to determine a cause for the reported leak (loss of fluid column).There is no indication of a product issue with respect to manufacture, design, or labeling.
 
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Brand Name
TRICLIP¿ STEERABLE GUIDE CATHETER
Common Device Name
TRICUSPID VALVE REPAIR DEVICE, PERCUTANEOUSLY DELIVERED
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT VASCULAR, REG # 3005070406
3885 bohannon drive
menlo park CA 94025
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key23660842
Report Number2135147-2025-06989
Device Sequence Number9123866
Product Code DQY
UDI-Device Identifier05415067047748
UDI-Public(01)05415067047748(17)260716(10)50116R1086
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
K241538
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 12/18/2025
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 Date07/16/2026
Device Model NumberTSGC0201
Device Catalogue NumberTSGC0201
Device Lot Number50116R1086
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 11/06/2025
Supplement Date Received by Manufacturer12/17/2025
Initial Report FDA Received Date11/26/2025
Supplement Report FDA Received Date12/18/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/16/2025
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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