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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL AMPLATZER SEPTAL OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER

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ABBOTT MEDICAL AMPLATZER SEPTAL OCCLUDER; TRANSCATHETER SEPTAL OCCLUDER Back to Search Results
Model Number 9-ASD-030
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 02/06/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that on (b)(6) 2026, a 30mm amplatzer septal occluder was chosen for a procedure using a 12f amplatzer trevisio intravascular delivery system.During the positioning, the left atrial disc assumed an incorrect form (cobra shape).The device was not implanted and removed from the patient.A new 30mm amplatzer septal occluder was used and implanted successfully using the first delivery system.The patient did not experienced any adverse consequences and this event was not attributed to patient anatomy.The patient was reported stable.
 
Additional Manufacturer Narrative
The device is expected to be returned for investigation.It has not yet been received.A follow-up report will be submitted with all additional relevant information.
 
Additional Manufacturer Narrative
An event of device deformity could not be confirmed.Imaging was received from field showing the distal disk deploying into a cobra like-deformation.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 specifications.Additionally, the lot was reviewed for similar complaints, and there is no indication of a lot-specific product issue.The cause of the reported device deformity could not be conclusively determined.There is no indication of a product quality issue with respect to labeling design or manufacturing of the device.
 
Event or Problem Description
It was reported that on (b)(6) 2026, a 30mm amplatzer septal occluder was chosen for a procedure using a 12f amplatzer trevisio intravascular delivery system.During the positioning, the left atrial disc assumed an incorrect form (cobra shape).The device was not implanted and removed from the patient.There was no report of any interaction with cardiac structures during deployment and no report of any angulation/kink noticed with the delivery system.The deformed device was never released from the delivery cable while inside the patient.A new 30mm amplatzer septal occluder was used and implanted successfully using the first delivery system.The patient did not experienced any adverse consequences and this event was not attributed to patient anatomy.The patient remained hemodynamically stable throughout the procedure.There was no clinically significant delay in procedure and no adverse patient effects.The patient was reported stable.
 
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Brand Name
AMPLATZER SEPTAL OCCLUDER
Common Device Name
TRANSCATHETER SEPTAL OCCLUDER
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ST. JUDE MEDICAL #3014918977
edificio #44 calle 0, ave. 2
el coyol alajuela 1897- 4050
CS   1897-4050
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key24501544
Report Number2135147-2026-01344
Device Sequence Number16066407
Product Code MLV
UDI-Device Identifier00811806010229
UDI-Public(01)00811806010229(17)300531(10)10923088
Combination Product (Y/N)N
Initial Reporter CountryIT
PMA/510(K) Number
P000039
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) 04/29/2026
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-ASD-030
Device Catalogue Number9-ASD-030
Device Lot Number10923088
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 02/06/2026
Supplement Date Received by Manufacturer04/17/2026
Initial Report FDA Received Date03/03/2026
Supplement Report FDA Received Date04/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/23/2025
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
12F AMPLATZER TREVISIO INTRAVASCULAR DELIVERY SYST
Patient SexUnknown
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