FDA Adverse Event Injury Summary report: N

INTEGRITY MICRO

MDR report key: 1050363 · Received May 27, 2008

Report

Report Number
2017865-2008-01264
Event Type
Injury
Date Received
May 27, 2008
Date of Event
February 8, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DXY
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NY
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PULSE GENERATOR WAS IN BACK-UP MODE. TWO ATTEMPTS TO PERFORM A DOWNLOAD FAILED. THE ERI BYTE WAS CHECKED INDICATING THE DEVICE WAS NOT AT ELECTIVE REPLACEMENT INDICATOR (ERI). THE MEASURED BATTERY DATA IN 2007 WAS 2.56 V, 14 UA, 8.7 KOHMS WITH AN ESTIMATED LONGEVITY OF ABOUT 2 MONTHS UNTIL ERI. THE DEVICE WAS SUBSEQUENTLY REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 INTEGRITY MICRO IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 5336 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention