FDA Adverse Event Injury Summary report: N

SPRINT

MDR report key: 1072881 · Received July 10, 2008

Report

Report Number
2649622-2008-03650
Event Type
Injury
Date Received
July 10, 2008
Date of Event
April 2, 2008
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
LWS
PMA / PMN Number
ASKU
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY
Reporter Occupation
INVALID DATA

Narratives

Description of Event or Problem · 1

IT WAS REPORTED THAT NOISE WAS DETECTED, WHICH WAS REPRODUCIBLE WITH ARM MOVEMENT. OVERSENSING AND LOW IMPEDANCE WAS ALSO INDICATED. THE LEAD WAS CAPPED AND REPLACED. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SPRINT IMPLANTABLE TACHY LEAD LWS MEDTRONIC PUERTO RICO, INC. 6945 ASKU

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention 7271 IMPLANTABLE PACEMAKER/CARDIO/DEFIB| 6940 IMPLANTABLE PACING LEAD