FDA Adverse Event Injury Summary report: N

SYMMETRY DR

MDR report key: 1223646 · Received November 10, 2008

Report

Report Number
2017865-2008-03220
Event Type
Injury
Date Received
November 10, 2008
Date of Event
July 15, 2008
Report Date
August 18, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DXY
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
PA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER AND MAUDE EVENT REPORT NUMBER.

Description of Event or Problem · 1

IT WAS REPORTED THAT WHILE IN ICU AFTER A ROUTINE CAROTID ENDARTERECTOMY, THE PATIENT BECAME UNRESPONSIVE AND VENTRIC- ULAR FIBRILLATION (VF) WAS SEEN. REVIEW OF THE MONITORING STRIPS SHOWED A PACED BEAT ON THE T WAVE. CARDIOPULMONARY RESUSCITATION COMMENCED FOR ABOUT 90 SECONDS. THE VF CEASED SPONTANEOUSLY, DUAL CHAMBER PACING RESUMED AND THE PATIENT RECOVERED. INTERROGATION OF THE PACEMAKER SHOWED APPROPRIATE FUNCTION. THE DEVICE WAS REPROGRAMMED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYMMETRY DR IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 5360 NA

Patients

Seq Age Sex Outcome Treatment
1 Required Intervention