FDA Adverse Event Injury Summary report: N

ISOFLEX S

MDR report key: 1073051 · Received July 11, 2008

Report

Report Number
2017865-2008-01987
Event Type
Injury
Date Received
July 11, 2008
Date of Event
April 16, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTRICULAR LEAD EXHIBITED LESS THAN 200 OHMS IMPEDANCE IN THE BIPOLAR CONFIGURATION. NOISE WAS PRODUCED WHEN THE PATIENT PERFORMED ISOMETRICS. THE PATIENT REPORTED BEING FATIGUED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ISOFLEX S PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1646T/52 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention