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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ABBOTT MEDICAL MITRACLIP G5 DELIVERY SYSTEM; MITRAL VALVE REPAIR DEVICES

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ABBOTT MEDICAL MITRACLIP G5 DELIVERY SYSTEM; MITRAL VALVE REPAIR DEVICES Back to Search Results
Model Number CDS0801-NTW
Medical Device Problem Code Retraction Problem (1536)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/26/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device has been received.However, 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 during preparation of a mitraclip ntw clip delivery system (cds), after attaching the drip line, the sleeve of the clip delivery system (cds) would not retract from the handle.Therefore, the clip was not used and was replaced.There was no clinically significant delay in the procedure.
 
Additional Manufacturer Narrative
All available information was investigated, and the reported difficult dc handle retraction was unable to be confirmed.A review of the lot history record revealed no manufacturing nonconformities issued to the reported lot that would have contributed to this event.Additionally, a review of the complaint history identified no similar complaints reported from this lot.The investigation was unable to determine the cause for the reported difficult dc handle retraction.There is no indication of a product quality issue with respect to manufacture, design, or labeling.
 
Event or Problem Description
It was reported that during preparation of a mitraclip ntw clip delivery system (cds), after attaching the drip line, the sleeve of the clip delivery system (cds) would not retract from the handle.Therefore, the clip was not used and was replaced.There was no clinically significant delay in the procedure.
 
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Brand Name
MITRACLIP G5 DELIVERY SYSTEM
Common Device Name
MITRAL VALVE REPAIR DEVICES
Manufacturer (Section D)
ABBOTT MEDICAL
5050 nathan lane n
plymouth MN 55442
Manufacturer (Section G)
ABBOTT MEDICAL NORTHPOINT REG 3020950818
1820 bastian court
westfield IN 46074
Manufacturer Contact
karen krouse
5050 nathan lane n
plymouth, MN 55442
6517565400
MDR Report Key24927879
Report Number2135147-2026-02557
Device Sequence Number10727665
Product Code NKM
UDI-Device Identifier05415067050748
UDI-Public(01)05415067050748(17)270127(10)50728A1022
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
P100009
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) 06/05/2026
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 NumberCDS0801-NTW
Device Catalogue NumberCDS0801-NTW
Device Lot Number50728A1022
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/08/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/26/2026
Supplement Date Received by Manufacturer05/29/2026
Initial Report FDA Received Date04/20/2026
Supplement Report FDA Received Date06/05/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/30/2025
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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