FDA Adverse Event Injury Summary report: N

CURRENT RF VR

MDR report key: 1073489 · Received July 11, 2008

Report

Report Number
2017865-2008-02268
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 5, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
PMAP910023
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Additional Manufacturer Narrative · 1

THE FIELD EVENT OF PREMATURE BATTERY DEPLETION WAS CONFIRMED IN THE LABORATORY. UPON RECEIPT, NO COMMUNICATION COULD BE ESTABLISHED WITH THE DEVICE. THE BATTERY VOLTAGE WAS FOUND TO BE VERY LOW. AN OPEN CIRCUIT ON THE HYBRID SUBASSEMBLY CAUSED CURRENT DRAINAGE, WHICH LED TO THE PREMATURE BATTERY DEPLETION.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE REACHED ERI PREMATURELY AFTER ONLY FOUR MONTHS OF IMPLANT. THE PATIENT HAS SINCE BEEN LOST TO FOLLOW-UP. IT IS UNKNOWN IF THE DEVICE REMAINS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURRENT RF VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1207-36 NA

Patients

Seq Age Sex Outcome Treatment
1 82 YR Required Intervention