FDA Adverse Event Injury Summary report: N

7229CX IMPLANTABLE PACEMAKER/CARDIO/DEFIB

MDR report key: 1072449 · Received July 10, 2008

Report

Report Number
2649622-2008-03944
Event Type
Injury
Date Received
July 10, 2008
Date of Event
May 19, 2008
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
LWS
Removal / Correction Number
NI
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
HI
Reporter Occupation
INVALID DATA

Narratives

Additional Manufacturer Narrative · 1

A GOOD FAITH EFFORT WILL BE MADE TO OBTAIN THE APPLICABLE INFORMATION RELEVANT TO THE REPORT. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

IT WAS LATER REPORTED THAT THE PATIENT HAS RECEIVED INAPPROPRIATE SHOCKS FROM THE RIGHT VENTRICULAR (RV) LEAD IN THE PAST DUE TO APPARENT EMI (ELECTROMAGNETIC INTERFERENCE). THE HIGH VOLTAGE PORTION OF THE LEAD REMAINS IN USE. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 7229CX IMPLANTABLE PACEMAKER/CARDIO/DEFIB DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MEDTRONIC PUERTO RICO, INC. 6945 NA

Patients

Seq Age Sex Outcome Treatment
1 70 YR Life Threatening| R