FDA Adverse Event Malfunction Summary report: N

KINETRA

MDR report key: 1061530 · Received June 17, 2008

Report

Report Number
9614453-2008-03268
Event Type
Malfunction
Date Received
June 17, 2008
Date of Event
February 1, 2008
Report Date
May 17, 2008
Manufacturer
MEDTRONIC SWISS MANUFACTURING FACILITY
Product Code
MHY
PMA / PMN Number
P960009
Removal / Correction Number
Z-0693-2008
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

UPON RECEIPT, THE DEVICE WAS FOUND IN A NO OUTPUT / NO TELEMETRY CONDITION. FURTHER ANALYSIS REVEALED BROKEN BOND WIRES CONNECTING THE BATTERY TO THE HYBRID CIRCUIT. THE EPOXY BOND BETWEEN THE HYBRID AND BOTH BATTERY TERMINALS WAS BROKEN. THE BATTERY STATUS WAS 2.64 VOLTS.

Description of Event or Problem · 1

IT WAS REPORTED INTERMITTENT POWER ON RESETS HAD OCCURRED SEVERAL TIMES DURING PROGRAMMING SESSIONS IN 2008. EVENTUALLY TELEMETRY WAS NO LONGER POSSIBLE; THE NEUROSTIMULATOR STOPPED FUNCTIONING. NO PATIENT INJURY WAS REPORTED. THE DEVICE WAS REPLACED. THE PATIENT'S THERAPY RESUMED AFTER REPLACEMENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 KINETRA MHY MEDTRONIC SWISS MANUFACTURING FACILITY 7428 NA

Patients

Seq Age Sex Outcome Treatment
1 UNK