FDA Adverse Event Injury Summary report: N

LEAD MODEL 302

MDR report key: 1120737 · Received August 15, 2008

Report

Report Number
1644487-2008-01916
Event Type
Injury
Date Received
August 15, 2008
Date of Event
June 1, 2008
Report Date
July 17, 2008
Manufacturer
CYBERONICS, INC.
Product Code
LYJ
PMA / PMN Number
P970003
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
NM, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

MANUFACTURER REVIEWED X-RAYS OF IMPLANTED DEVICE. X-RAYS REVIEWED BY THE MANUFACTURER, NO GROSS LEAD DISCONTINUITIES VISUALIZED.

Description of Event or Problem · 1

REPORTER INDICATED THAT AFTER A VNS PATIENT RECEIVED CARDIAC DEFIBRILLATION AT HOME, SHE DEVELOPED STABBING, INTERMITTENT NECK PAIN. DEVICE DIAGNOSTICS WERE NORMAL. THE VNS WAS DISABLED AND THE PATIENT WAS SENT FOR A SURGICAL CONSULT. X-RAY REVIEW BY THE MANUFACTURER DID NOT REVEAL ANY LEAD ANOMALIES. THE PATIENT LATER UNDERWENT VNS LEAD AND GENERATOR REVISION SURGERY. THE EXPLANTED DEVICES HAVE BEEN RETURNED AND ARE CURRENTLY IN PRODUCT ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 LEAD MODEL 302 LYJ CYBERONICS, INC. 302-20 1080

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention