EP DIAGNOSTIC CATHETER LIVEWIRE DECA EXTRA LARGE CURL
Received Dec 14, 2021 · Event occurred Nov 23, 2021
Report 2134070-2021-00031 · MDR key 13002698
Device
Generic name
Catheter, Recording, Electrode, Reprocessed
Manufacturer
Sterilmed, Inc.Model number
DAI401941Catalog number
DAI401941
Lot number
2142912
Product problems
- Material Separation
- Material Separation
Patient
Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
IT WAS REPORTED THAT A PATIENT UNDERWENT A PREMATURE VENTRICULAR CONTRACTION PROCEDURE WITH A REPROCESSED EP DIAGNOSTIC CATHETER LIVEWIRE DECA EXTRA LARGE CURL AND THERE WAS A SEPARATION WHERE THE LAST ELECTRODE CONNECTS TO THE SHAFT OF THE CATHETER WITH INTERNAL COMPONENTS EXPOSED. MULTIPLE ATTEMPTS HAVE BEEN COMPLETED TO OBTAIN PRODUCT RETURN STATUS OR TRACKING INFORMATION, TO NO AVAIL. A MANUFACTURING RECORD EVALUATION WAS PERFORMED, AND NO INTERNAL ACTIONS RELATED TO THE COMPLAINT WERE FOUND DURING THE REVIEW. NO DEVICE WAS RECEIVED FOR ANALYSIS AT THIS TIME. SINCE THE PRODUCT WAS NOT RETURNED FOR ANALYSIS, NO PRODUCT FAILURE ANALYSIS CAN BE CONDUCTED, AND NO DETERMINATION OF POSSIBLE CONTRIBUTING FACTORS COULD BE MADE. IF ADDITIONAL INFORMATION IS RECEIVED REGARDING THIS EVENT, A SUPPLEMENTAL 3500A REPORT WILL BE SUBMITTED TO THE FDA. MANUFACTURER'S REF. NO: (B)(4).
Additional Manufacturer Narrative
THE DEVICE HAS NOT YET BEEN RETURNED FOR ANALYSIS. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL REPORT, A FOLLOW-UP REPORT WILL BE FILED AS APPROPRIATE. MANUFACTURER'S REF. NO: (B)(4).
Description of Event or Problem
IT WAS REPORTED THAT A PATIENT UNDERWENT A PREMATURE VENTRICULAR CONTRACTION PROCEDURE WITH A REPROCESSED EP DIAGNOSTIC CATHETER LIVEWIRE DECA EXTRA LARGE CURL AND THERE WAS A SEPARATION WHERE THE LAST ELECTRODE CONNECTS TO THE SHAFT OF THE CATHETER WITH INTERNAL COMPONENTS EXPOSED. THE PACKAGE WAS OPENED AT THE TIME THE PHYSICIAN REQUESTED THE DEVICE FOR USED, HOWEVER, IT IS UNKNOWN IF THERE WAS ANY PHYSICAL DAMAGE TO THE PACKAGING. THERE WAS NO PATIENT CONSEQUENCE.