MAUDE Adverse Event Report: ABBOTT VASCULAR MITRACLIP SYSTEM STEERABLE GUIDE CATHETER VALVE REPAIR

Model Number UNK SGC03

Device Problem Peeled/Delaminated (1454)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 07/01/2014

Event Type  malfunction  

Manufacturer Narrative

Attachment article, titled: "cerebral protection during mitraclip implantation. ¿ exemption number (b)(4) permits numbering sequence to begin with 10000, to avoid duplication of report numbers due to process transition. There may be gaps in numbering for reports submitted during the transition period. The device is not returning. Investigation is not yet complete. A follow up report will be submitted with all additional relevant information. The clip delivery system (cds) mentioned in the article is filed under a separate medwatch report number. Na.

Event Description

This is being filed to report peeling. It was reported through a research article identifying mitraclip and that may be related to the following:mitral stenosis, tissue damage, thrombosis, foreign material, embolism and prolonged hospitalization. The article also identified steerable guide catheters that may be related to the following: thrombosis, tissue damage, foreign material, prolonged hospitalization and peeling. Specific patient information is documented as unknown. Details are listed in the attached article, titled, cerebral protection during mitraclip implantation. No additional information was provided.

• Brand Name: MITRACLIP SYSTEM STEERABLE GUIDE CATHETER
• Type of Device: VALVE REPAIR
• Manufacturer (Section D): ABBOTT VASCULAR; 26531 ynez rd.; temecula CA 92591 4628
• Manufacturer (Section G): ABBOTT VASCULAR, REG # 3005070406; 3885 bohannon drive; menlo park CA
• Manufacturer Contact: lindsey bell ; 26531 ynez rd.; temecula, CA 92591-4628 ; 9519143996
• MDR Report Key: 8920773
• MDR Text Key: 155214537
• Report Number: 2024168-2019-11053
• Device Sequence Number: 1
• Product Code: DRA
• Combination Product (y/n): N
• Reporter Country Code: GM
• PMA/PMN Number: K161985
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: literature

Reporter Occupation

• Type of Report: Initial,Followup,Followup
• Report Date: 07/22/2020

1 Device was Involved in the Event

0 Patients were Involved in the Event:

• Date FDA Received: 08/22/2019
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes

Device Operator

• Device Model Number: UNK SGC03
• Device Catalogue Number: UNK SGC03
• Was Device Available for Evaluation?: No
• Date Returned to Manufacturer: 07/31/2019
• Is the Reporter a Health Professional?: Yes

Was the Report Sent to FDA?

• Event Location: No Information
• Date Manufacturer Received: 07/20/2020
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial