BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RIATA ST OPTIM ACTIVE FIXATION

    MDR report key: 1223106 · Received November 10, 2008

    Report

    Report Number
    2017865-2008-03760
    Event Type
    Malfunction
    Date Received
    November 10, 2008
    Date of Event
    September 17, 2008
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    LWS
    PMA / PMN Number
    PMAP95022
    Removal / Correction Number
    NA
    Report Source
    Manufacturer report
    Reporter Location
    OH
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    NA

    Description of Event or Problem · 1

    IT WAS REPORTED THAT AN INCREASE IN CAPTURE THRESHOLD WAS NOTED. IT WAS ALSO STATED THAT PACING LEAD IMPEDANCE DECREASED. THE PATIENT HAD BEEN LOST TO FOLLOW-UP SINCE IMPLANT. FURTHER INFORMATION COULD NOT BE OBTAINED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RIATA ST OPTIM ACTIVE FIXATION DEFIBRILLATION LEAD LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 7022/65 NA

    Patients

    Seq Age Sex Outcome Treatment
    1