FDA Adverse Event Injury Summary report: N

RIATA ACTIVE FIXATION

MDR report key: 1223605 · Received November 10, 2008

Report

Report Number
2017865-2008-03594
Event Type
Injury
Date Received
November 10, 2008
Date of Event
March 5, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
PMAP95022
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
IL
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD TWIDDLER'S SYNDROME. IN 2008, PHYSICIAN HAD UNSNARLED THE TWIDDLED LEADS AND PLACED THE DEVICE SUB-PECTORALLY. PATIENT WAS CHECKED POST-OP AND HAD NOT BEEN IN SINCE THAT CHECK-UP UNTIL APPROX FIVE AND A HALF MONTHS LATER. INTERROGATION OF THE DEVICE REVEALED TACHYCARDIA EPISODES DUE TO NOISE ON THE LEADS. PHYSICIAN DECIDED TO CAP BOTH LEADS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RIATA ACTIVE FIXATION DEFIBRILLATION LEAD LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 1580/60 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention