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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Medtronic Heart Valves Division Freestyle Aortic Root Bioprosthesis; HEART-VALVE, NON-ALLOGRAFT TISSUE

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Medtronic Heart Valves Division Freestyle Aortic Root Bioprosthesis; HEART-VALVE, NON-ALLOGRAFT TISSUE Back to Search Results
Model Number FR995-23
Medical Device Problem Code Device Stenosis (4066)
Health Effect - Clinical Code Aortic Valve Stenosis (1717)
Date of Event 09/23/2026
Type of Reportable Event Malfunction
Event or Problem Description
Medtronic received information that 7 years and 7 months post implant of this 23mm aortic bioprosthetic valve, the patient is being evaluated for a transcatheter valve-in-valve replacement.The reason for evaluation was reported as aortic valve stenosis (as).No intervention or additional adverse patient effects were reported.
 
Additional Manufacturer Narrative
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.
 
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Brand Name
Freestyle Aortic Root Bioprosthesis
Common Device Name
HEART-VALVE, NON-ALLOGRAFT TISSUE
Manufacturer (Section D)
Medtronic Heart Valves Division
1851 e deere ave
santa ana CA 92705
Manufacturer (Section G)
Medtronic Heart Valves Division
1851 e deere ave
santa ana CA 92705
Manufacturer Contact
alison sweeney
parkmore business park west
galway 
EI  
+353(091)708096
MDR Report Key50894945
Report Number2025587-2026-01092
Device Sequence Number14928408
Product Code LWR
UDI-Device Identifier00643169002135
UDI-Public(01)00643169002135(17)230911
Combination Product (Y/N)N
Initial Reporter StateIN
Initial Reporter CountryUS
PMA/510(K) Number
P970031
Number of Events Summarized1
Summary Report (Y/N)N
Device Implanted Year2019
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) 09/25/2026
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 Expiration Date09/11/2023
Device Model NumberFR995-23
Device Catalogue NumberFR995-23
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 09/23/2026
Supplement Date Received by ManufacturerNot provided
Initial Report FDA Received Date09/25/2026
Supplement Report FDA Received Date09/25/2026
Date Device Manufactured09/12/2018
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 Age56 YR
Patient SexFemale
Patient Weight194 LB
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