FDA Adverse Event Malfunction Summary report: N

ISOFLEX S

MDR report key: 1073467 · Received July 11, 2008

Report

Report Number
2017865-2008-01982
Event Type
Malfunction
Date Received
July 11, 2008
Date of Event
April 1, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DTB
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Location
CA
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 DURING A ROUTINE FOLLOW-UP, INTERROGATION REVEALED A RISE IN VENTRICULAR THRESHOLDS AND LEAD IMPEDANCES. OUTPUT WAS SET TO 2.5 V WITH AUTOCAPTURE ON AT THE TIME OF IMPLANT, AND HAD RISEN TO3.5 V. LEAD IMPEDANCE WAS 746 OHMS AT TIME OF IMPLANT, AND HAD RISEN TO 1050 OHMS. THE PATIENT WILL BE MONITORED CLOSELY.

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