FDA Adverse Event Malfunction Summary report: N

SYMPHONY

MDR report key: 1162503 · Received September 16, 2008

Report

Report Number
9610579-2008-00031
Event Type
Malfunction
Date Received
September 16, 2008
Date of Event
August 7, 2008
Report Date
September 16, 2008
Manufacturer
ELA MEDICAL
Product Code
DXY
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THIS EVENT CONCERNS A DEVICE THAT WAS MANUFACTURED AND USED OUTSIDE THE UNITED STATES. THE DEVICE ANALYSIS IS PENDING.

Description of Event or Problem · 1

DURING ROUTINE FOLLOW UP IN 2008, ABSENCE OF CAPTURE AND SENSING WAS OBSERVED; IN ADDITION, HIGH LEAD IMPEDANCES WERE OBTAINED DURING THAT FOLLOW UP. THEREFORE, THE DEVICE WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYMPHONY DXY - IMPLANTABLE CARDIAC PACEMAKER DXY ELA MEDICAL 2550 S061005

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention