FDA Adverse Event Injury Summary report: N

RIATA ST ACTIVE FIXATION LEAD

MDR report key: 1073126 · Received July 11, 2008

Report

Report Number
2017865-2008-02368
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 14, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE ANALYSIS OF THE LEAD DID NOT REVEAL ANY DEVICE CONDITION THAT WOULD HAVE CONTRIBUTED TO THE REPORTED EVENT. THE LEAD EXHIBITED NORMAL ELECTRICAL CHARACTERISTICS. NORMAL LEAD IMPEDANCE WAS MEASURED. MECHANICAL AND VISUAL ANALYSIS FOUND DRIED BODY FLUID/TISSUE INSIDE THE HEADER AND INSIDE THE DISTAL INSULATION/COIL, PREVENTING HELIX ACTUATION. THE ENSUING RESISTANCE MAY HAVE RESULTED IN AN OVER-TORQUE CONDITION. THERE WAS NO INDICATION OF DEFECTS IN MATERIALS OR WORKMANSHIP.

Description of Event or Problem · 1

THE LEAD WAS EXPLANTED WHEN A DROP IN SENSING AND AN INCREASE IN IMPEDANCE WERE OBSERVED. A LEAD ANOMALY WAS SUSPECTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RIATA ST ACTIVE FIXATION LEAD DEFIBRILLATION LEAD LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 7000/65 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention