FDA Adverse Event Injury Summary report: N

RIATA ACTIVE FIXATION LEAD

MDR report key: 1073598 · Received July 11, 2008

Report

Report Number
2017865-2008-02482
Event Type
Injury
Date Received
July 11, 2008
Date of Event
May 9, 2008
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 Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ANALYSIS FOUND THAT THE LEAD EXHIBITED NORMAL ELECTRICAL CHARACTERISTICS. ABRASION MARKS WERE OBSERVED ON THE OUTER INSULATION AT 9, 10, AND 11 CM FROM THE LEAD TIP. THE LEAD WAS POSITIONED IN AN AREA PASSING THE TRICUSPID VALVE. THE DAMAGE IS BELIEVED TO BE CAUSED OVER TIME BY THE CLOSING OF THE VALVE. DRIED BODY FLUID INSIDE THE HEADER, THE INNER INSULATION AND COIL PREVENTED PROPER DISTAL COIL ROTATION, RESULTING IN AN OVERTORQUE CONDITION.

Description of Event or Problem · 1

IT WAS REPORTED THE LEAD WAS EXPLANTED DUE TO HIGH IMPEDANCE AS A RESULT OF AN INSULATION ANOMALY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RIATA ACTIVE FIXATION LEAD DEFIBRILLATION LEAD LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1580/65 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention