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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 D128208
Medical Device Problem Code Obstruction of Flow (2423)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/11/2025
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 (afib) ablation procedure with a pentaray nav and an irrigation issue occurred.During the ablation procedure, they noticed the irrigation was not flowing out of the pentaray.The physician tried to flush with a syringe, but no irrigation came out of the catheter.They changed to a new catheter.There was no visible damage to the catheter.No error message on carto system.There was no signal noise on carto and ep recording system.There was no adverse patient consequence reported.
 
Additional Manufacturer Narrative
The device was returned to johnson & johnson medtech (j&j) for evaluation on 15-jan-2026.Therefore, section d9 was populated.It was reported that a patient underwent an atrial fibrillation (afib) ablation procedure with a pentaray nav and an irrigation issue occurred.Device investigation details: visual inspection and irrigation test of the returned device were performed following j&j procedures.Visual analysis revealed no damage or anomalies on the device.An irrigation test was performed, and the catheter failed the test since no flow was observed.Afterwards, an aluminum wire was introduced in the luer hub, and the wire got stuck at the tip area.The tip was dissected and the irrigation tube was inspected, and it was found the irrigation tube folded into a "z" shape in the transition between the tip to the sheath.This failure mode was identified as manufacturing related.A manufacturing record evaluation was performed and no internal actions related to the reported complaint condition were identified.The irrigation issue reported by the customer was confirmed.The root cause of the folded irrigation tubing is traced to the manufacturing process.The instruction for use (ifu) contain the following warning and precautions: 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.An internal corrective action has been opened to investigate this failure mode.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 Key24017553
Report Number2029046-2026-00085
Device Sequence Number8970176
Product Code MTD
UDI-Device Identifier10846835012224
UDI-Public(01)10846835012224(17)280416(10)31631227L
Combination Product (Y/N)N
Initial Reporter CountryFR
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 Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 02/10/2026
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 NumberD128208
Device Lot Number31631227L
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 12/11/2025
Supplement Date Received by Manufacturer01/15/2026
Initial Report FDA Received Date01/09/2026
Supplement Report FDA Received Date02/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/17/2025
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
UNK_CARTO 3
Patient SexUnknown
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