FDA Adverse Event Injury Summary report: N

ISOFLEX S

MDR report key: 1073310 · Received July 11, 2008

Report

Report Number
2017865-2008-02104
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 23, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
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

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE VENTRICULAR LEAD EXHIBITED CAPTURE THRESHOLDS OF 6.5 V, 0.6 MS IN THE UNIPOLAR CONFIGURATION. THE PATIENT COULD NOT CAPTURE AT 7.0 V, 0.6 MS IN THE BI- POLAR CONFIGURATION. AN X-RAY DID NOT SHOW ANY EVIDENCE OF LEAD INTEGRITY BEING COMPROMISED. THE PATIENT HAD BEEN FEELING VERY SLEEPY IN THE LAST MONTH. THE LEAD WAS SUB- SEQUENTLY REPLACED.

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/58 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention