FDA Adverse Event Malfunction Summary report: N

AFFINITY DR

MDR report key: 1073324 · Received July 11, 2008

Report

Report Number
2017865-2008-02118
Event Type
Malfunction
Date Received
July 11, 2008
Date of Event
May 16, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DXY
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

FINAL ANALYSIS FOUND A BATTERY IMPEDANCE ANOMALY DUE TO A CONDUCTIVE EPOXY BOND ANOMALY. NO COMPLAINT WAS RECEIVED WITH RETURN OF THE DEVICE. FAILURE (EVENT) OBSERVED DURING ANALYSIS.

Description of Event or Problem · 1

THIS REPORT IS TO ADVISE OF AN EVENT OBSERVED DURING ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 AFFINITY DR IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 5330R NA

Patients

Seq Age Sex Outcome Treatment
1