FDA Adverse Event Malfunction Summary report: N

QUICKSITE LV

MDR report key: 1073404 · Received July 11, 2008

Report

Report Number
2017865-2008-02193
Event Type
Malfunction
Date Received
July 11, 2008
Date of Event
May 1, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA
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

THE ASYMPTOMATIC PATIENT PRESENTED IN THE CLINIC FOR A ROUTINE FOLLOW-UP. AT IMPLANT THE LEAD IMPEDANCE WAS 750 OHMS BUT WAS 207 OHMS AT THE FOLLOW-UP. CAPTURE THRESHOLDS HAD INCREASED FROM 0.8 V TO 2.2 V.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 QUICKSITE LV PERMANENT PACEMAKER ELECTRODE DTB ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1056T/86 NA

Patients

Seq Age Sex Outcome Treatment
1