FDA Adverse Event Malfunction Summary report: N

ATLAS PLUS DR

MDR report key: 1223289 · Received November 10, 2008

Report

Report Number
2017865-2008-03689
Event Type
Malfunction
Date Received
November 10, 2008
Date of Event
August 6, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
PMAP910023
Removal / Correction Number
NA
Report Source
Manufacturer report
Reporter Location
NY
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

THE PATIENT RECEIVED INAPPROPRIATE THERAPY DUE TO OVERSENSING. THE STRIPS SEEMED LIKE THE PATIENT WAS VERY SICK OR HAD AN ELECTROLYTE IMBALANCE DUE TO THE AMPLITUDE VARIATION AND TACHYCARDIA APPEARANCE. IT WAS NOTED THAT THE PATIENT WAS A DNR STATUS. THE PHYSICIAN DECIDED TO TURN THE ICD HIGH VOLTAGE THERAPY OFF. THE DEVICE REMAINS IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLAS PLUS DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-243 NA

Patients

Seq Age Sex Outcome Treatment
1