FDA Adverse Event Malfunction Summary report: N

ITREVIA 7 VR-T DX DF-1 PROMRI

MDR report key: 11760323 · Received May 3, 2021

Report

Report Number
1028232-2021-02195
Event Type
Malfunction
Date Received
May 3, 2021
Date of Event
March 18, 2021
Report Date
March 26, 2021
Manufacturer
BIOTRONIK SE & CO. KG
Product Code
LWS
PMA / PMN Number
P050023
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
DE
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PRIOR TO THE ANALYSIS OF THE DEVICE, THE QUALITY DOCUMENTS ACCOMPANYING THE MANUFACTURING PROCESS OF THIS ICD WERE REVIEWED. THE PRODUCTION DOCUMENTS SHOWED NO ANOMALIES. ALL MANUFACTURING STEPS HAD BEEN CARRIED OUT CORRECTLY. A PERFORMED STANDARD FINAL ELECTRICAL TEST DOCUMENTED PROPER DEVICE BEHAVIOR. SUBSEQUENTLY, THE ICD UNDERWENT A STATUS INTERROGATION WITH A CLINICAL PROGRAMMER, AND THE DEVICE MEMORY WAS ANALYZED. MATCHING THE CLINICAL OBSERVATION, THE ICD SHOWED THE DEVICE STATUS ERI. THE CHARGE DRAWN FROM THE BATTERY WAS CHECKED, REVEALING AN INCONSISTENCY BETWEEN DRAWN CHARGE AND MEASURED BATTERY VOLTAGE. PREMATURE BATTERY DEPLETION WAS CONFIRMED DURING THE ANALYSIS. THIS DEVICE IS AFFECTED BY THE CORRECTIVE SAFETY MEASURE IN THE FIELD, BIO-LOQ, THAT WAS COMMUNICATED IN MARCH 2021.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE WAS EXPLANTED DUE TO ERI STATUS APPROX. 61 MONTHS AFTER THE IMPLANTATION. PLEASE NOTE THIS ICD IS AFFECTED BY A FIELD SAFETY CORRECTIVE ACTION, BIO-LQC, INITIATED IN MARCH 2021.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
661680 ITREVIA 7 VR-T DX DF-1 PROMRI ICD LWS BIOTRONIK SE & CO. KG 393036

Patients

Seq Age Sex Outcome Treatment
1