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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDTRONIC MEXICO S. DE R.L. DE CV EVOLUT FX VALVE; AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIV

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MEDTRONIC MEXICO S. DE R.L. DE CV EVOLUT FX VALVE; AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIV Back to Search Results
Model Number EVOLUTFX-34
Medical Device Problem Code Patient Device Interaction Problem (4001)
Health Effect - Clinical Codes Arrhythmia (1721); Bradycardia (1751)
Date of Event 07/10/2024
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
Continuation of d10: product id: {d-evolutfx-34}; product lot/serial number: {unknown}; product type: {0195-heartvalves}.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
It was reported that 1 day following the implant of this transcatheter bioprosthetic valve, a permanent pacemaker was implanted due to sinus bradycardia and atrial arrhythmias.
 
Additional Manufacturer Narrative
Updated data: b5.H6.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
It was reported that 1 day following the implant of this transcatheter bioprosthetic valve, a permanent pacemaker was implanted due to sinus bradycardia and atrial arrhythmias.Additional information was received that the sinus bradycardia and atrial arrhythmias first occurred one day following the implant of the valve.
 
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Brand Name
EVOLUT FX VALVE
Common Device Name
AORTIC VALVE, PROSTHESIS, PERCUTANEOUSLY DELIV
Manufacturer (Section D)
MEDTRONIC MEXICO S. DE R.L. DE CV
av. paseo del cucapah #10510
tijuana,bc 22210
MX  22210
Manufacturer (Section G)
MEDTRONIC MEXICO S. DE R.L. DE CV
av. paseo del cucapah #10510
tijuana,bc 22210
MX   22210
Manufacturer Contact
alison sweeney
parkmore business park west
galway 
EI  
091708096
MDR Report Key24269138
Report Number9617601-2026-00970
Device Sequence Number10030964
Product Code NPT
UDI-Device Identifier00763000370718
UDI-Public(01)00763000370718(17)260412
Combination Product (Y/N)N
Initial Reporter StateMS
Initial Reporter CountryUS
PMA/510(K) Number
P130021
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2024
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) 04/10/2026
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Health Professional
Device Expiration Date04/12/2026
Device Model NumberEVOLUTFX-34
Device Catalogue NumberEVOLUTFX-34
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 02/01/2026
Supplement Date Received by Manufacturer03/23/2026
Initial Report FDA Received Date02/05/2026
Supplement Report FDA Received Date04/11/2026
Date Device Manufactured04/12/2024
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
Outcome Attributed to Adverse Event Required Intervention;
Patient Age84 YR
Patient SexMale
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