inforMED
MalfunctionLDF

PACEL FLOW DIRECTED PACING CATHETER

Received May 6, 2025 · Event occurred Dec 16, 2024

Report 2182269-2025-00022 · MDR key 21969955

Device

Generic name

Electrode, Pacemaker, Temporary

Manufacturer

St. Jude Medical

Model number

401764

Catalog number

401764

Lot number

10394001

Product problems

  • Inflation Problem
  • Material Separation
  • Inflation Problem
  • Material Separation

Patient

NA · Unknown

  • No Clinical Signs, Symptoms or Conditions
  • No Clinical Signs, Symptoms or Conditions

Narrative

Additional Manufacturer Narrative

ONE 5F PACEL (FLOW DIRECTED) PACING CATHETER WAS RECEIVED FOR EVALUATION. THE 1.25CC VOLUME LIMITED SYRINGE WAS ALSO RETURNED. THE REPORTED EVENT OF A RUPTURED BALLOON WAS CONFIRMED. THE BALLOON WAS NOTED TO BE TORN AND RUPTURED WHERE THE ADHESIVE SEAL MEETS THE BALLOON AT THE PROXIMAL END OF THE BALLOON. THE PROXIMAL AND DISTAL ADHESIVE BONDS FOR THE BALLOON REMAINED INTACT. THE DEVICE HISTORY RECORD WAS REVIEWED TO ENSURE THAT EACH MANUFACTURING AND INSPECTION OPERATION WAS PERFORMED. THE CAUSE OF THE TORN AND RUPTURED BALLOON REMAINS UNKNOWN.

Description of Event or Problem

DURING THE PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA PROCEDURE, A PACING CATHETER WAS INSERTED INTO THE PATIENT AND BLOOD RETURNED TO THE SYRINGE. THE CATHETER WAS REMOVED, AND THE TIP OF THE BALLOON WAS FOUND TO BE RUPTURED. THE CATHETER WAS EXCHANGED, AND THE PROCEDURE WAS COMPLETED WITH NO ADVERSE CONSEQUENCES TO THE PATIENT.