FDA Adverse Event Injury Summary report: N

CURRENT VR RF

MDR report key: 1073490 · Received July 11, 2008

Report

Report Number
2017865-2008-02269
Event Type
Injury
Date Received
July 11, 2008
Date of Event
December 20, 2007
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
PMA00001
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
OH
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. REVIEW OF QUALITY RECORDS THE DEVICE WAS FOUND TO BE ABOVE ELECTIVE REPLACEMENT INDICATOR (ERI). TESTING REVEALED NORMAL DEVICE CHARACTERISTICS. NO ANOMALOUS BEHAVIOR WAS OBSERVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SYSTEM WAS REMOVED DUE TO INFECTION.

Devices

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

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention