FDA Adverse Event Injury Summary report: N

ATLAS PLUS HF CRT-D

MDR report key: 1223765 · Received November 10, 2008

Report

Report Number
2017865-2008-03509
Event Type
Injury
Date Received
November 10, 2008
Date of Event
August 18, 2008
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NIK
PMA / PMN Number
P030054
Removal / Correction Number
NA
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
TX
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WOULD NOT COMMUNICATE DUE TO A DEPLETED BATTERY. THE DEVICE WAS ANALYZED WITH A NEW BATTERY AND FOUND TO BE NORMAL. FURTHER ANALYSIS IDENTIFIED AN INTERNAL ANOMALY WITHIN THE BATTERY. THIS ANOMALY CAUSED THE LOW BATTERY VOLTAGE AND NO COMMUNICATION EXPERIENCED IN THE FIELD.

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE COULD NOT BE INTERROGATED. THE LAST KNOWN BATTERY VOLTAGE WAS 2.95V. EKG DID NOT SHOW PACING. THE DECISION WAS MADE TO EXPLANT THE DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLAS PLUS HF CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-343 NA

Patients

Seq Age Sex Outcome Treatment
1 82 YR Required Intervention