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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOSENSE WEBSTER INC PENTARAY NAV; CATHETER, INTRACARDIAC MAPPING, HIGH-DENSITY ARRAY

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BIOSENSE WEBSTER INC PENTARAY NAV; CATHETER, INTRACARDIAC MAPPING, HIGH-DENSITY ARRAY Back to Search Results
Catalog Number D128210
Medical Device Problem Code Obstruction of Flow (2423)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/05/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by biosense webster, inc., or its employees that the report constitutes an admission that the product, biosense webster, inc.Or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.Manufacturer's reference number: (b)(4).
 
Event or Problem Description
It was reported that a patient underwent an atrial fibrillation - paroxysmal ablation procedure with a pentaray nav catheter and the device (including port, luer hub) was not irrigating.A pressurized saline bag was used to resolve the issue; however, it did not produce water.The smartablate was then used for rinsing--to no avail.The catheter had been used inside of the patient.There were no flow rate changes or issues at the start of the procedure.The correct catheter settings had been selected on the generator.A second device was used to complete the operation.There was no adverse event reported on patient.
 
Additional Manufacturer Narrative
On 6-jan-2026, the bwi product analysis lab received the device for evaluation.The product investigation was subsequently completed.It was reported that a patient underwent an atrial fibrillation - paroxysmal ablation procedure with a pentaray nav catheter and the device (including port, luer hub) was not irrigating.A pressurized saline bag was used to resolve the issue; however, it did not produce water.The smartablate was then used for rinsing--to no avail.Device evaluation details: the device was returned to johnson & johnson medtech (j&j medtech) for evaluation.Following j&j medtech procedures, a visual inspection and irrigation test of the returned device were performed.Visual inspection revealed no damage or anomalies on the device.An irrigation test was performed, and the catheter failed the test due to the irrigation tube was found folded at the tip area.A manufacturing record evaluation was performed for the finished device lot number 31695065l and no internal action was found during the review.The irrigation issue reported by the customer was confirmed.The root cause of the irrigation tube folded is traced to manufacturing process.The instructions for use (ifu) contain the following information: flush the catheter with heparinized saline prior to insertion into the body.Always follow standard practices of using a continuous drip of anticoagulant fluid under pressure through the proximal luer connector when the device is in the body.This product issue will be addressed through the quality system.An internal action was opened to investigate this failure mode on pentaray catheters.If additional information is received regarding this event, a supplemental 3500a report will be submitted to the fda.Manufacturer's reference number: (b)(4).
 
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Brand Name
PENTARAY NAV
Common Device Name
CATHETER, INTRACARDIAC MAPPING, HIGH-DENSITY ARRAY
Manufacturer (Section D)
BIOSENSE WEBSTER INC
31 technology drive, suite 200
irvine CA 92618
Manufacturer (Section G)
BIOSENSE WEBSTER INC (JUAREZ)
circuito interior norte
1820parque industrial salvacar
juarez 32599
MX   32599
Manufacturer Contact
henry boden
31 technology dr
irvine, CA 92618
9497882078
MDR Report Key23916466
Report Number2029046-2025-04333
Device Sequence Number9963942
Product Code MTD
UDI-Device Identifier10846835012248
UDI-Public(01)10846835012248(17)280627(10)31695065L
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K123837
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 01/26/2026
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 Catalogue NumberD128210
Device Lot Number31695065L
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/09/2025
Supplement Date Received by Manufacturer01/06/2026
Initial Report FDA Received Date12/29/2025
Supplement Report FDA Received Date01/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/28/2025
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
Concomitant Medical Products
and Therapy/Usage Dates
SMARTABLATE GENERATOR.; SMARTABLATE PUMP.
Patient SexUnknown
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