FDA Adverse Event Injury Summary report: N

TRILOGY DR+

MDR report key: 1050607 · Received May 27, 2008

Report

Report Number
2017865-2008-01574
Event Type
Injury
Date Received
May 27, 2008
Date of Event
March 3, 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
OR
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 PATIENT PRESENTED IN FULL CODE IN THE EMERGENCY ROOM, AND DEVICE TELEMETRY COULD NOT BE ESTABLISHED. IN MAY 2007 THE ESTIMATED LONGEVITY WAS TWO MONTHS. THE PATIENT WAS THEN PUT ON MONTHLY FOLLOW-UPS. ONE MONTH PRIOR TO THE EVENT, THE PATIENT HAD A MAGNET RATE OF 70 PPM, THE SAME AS THE PREVIOUSLY PROGRAMMED BASE RATE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 TRILOGY DR+ IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 2360L NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention