FDA Adverse Event Injury Summary report: N

CURRENT RF DR

MDR report key: 1073068 · Received July 11, 2008

Report

Report Number
2017865-2008-02314
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 5, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

DURING FOLLOW-UP, A SENSING ANOMALY WAS OBSERVED. X-RAY SHOWED DEVICE MIGRATION AND LEAD DISLODGMENT. DURING THE PROCEDURE, TWIDDLER SYNDROME WAS CONFIRMED. THE DEVICE AND LEADS WERE REPOSITIONED AND REMAIN IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURRENT RF DR IMPLANTIBLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 2207-36 NA

Patients

Seq Age Sex Outcome Treatment
1 70 YR Required Intervention