FDA Adverse Event Injury Summary report: N

MEDTRONIC ICD

MDR report key: 12962743 · Received December 8, 2021

Report

Report Number
2182208-2021-04820
Event Type
Injury
Date Received
December 8, 2021
Date of Event
January 1, 2021
Report Date
December 8, 2021
Manufacturer
MEDTRONIC, INC.
Product Code
DXY
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS INFORMATION IS BASED ENTIRELY ON JOURNAL LITERATURE. MEDTRONIC WAS MADE AWARE OF THIS EVENT THROUGH A SEARCH OF LITERATURE PUBLICATIONS. OF NOTE, MULTIPLE PATIENTS AND MULTIPLE MANUFACTURERS WERE NOTED IN THE ARTICLE; HOWEVER, A ONE-TO-ONE CORRELATION COULD NOT BE MADE WITH UNIQUE PRODUCT SERIAL/LOT NUMBERS. THE BASELINE GENDER/AGE CHARACTERISTICS IS MALE/60 YEARS OLD. THE MODEL LISTED IN THE REPORT IS A REPRESENTATIVE OF THE MODEL FAMILY, AS THERE IS NO SPECIFIC MODEL LISTED. WITHOUT A LOT NUMBER OR DEVICE SERIAL NUMBER, THE MANUFACTURING DATE CANNOT BE DETERMINED. SINCE NO DEVICE ID WAS PROVIDED, IT IS UNKNOWN IF THIS EVENT HAS BEEN PREVIOUSLY REPORTED. A REQUEST FOR ADDITIONAL INFORMATION WILL BE MADE AND UPON RECEIPT A SUPPLEMENTAL REPORT WILL BE SUBMITTED ACCORDINGLY. REFERENCED ARTICLE: SURVIVAL AFTER IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR SHOCKS. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. 2021. 77(20):2453-2462. DOI.ORG/10.1016/J.JACC.2021.03.329. IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 0

A JOURNAL ARTICLE WAS REVIEWED THAT CONTAINED INFORMATION REGARDING SURVIVAL AFTER IMPLANTABLE CARDIOVERTER DEFIBRILLATOR (ICD) SHOCKS. THE ARTICLE REPORTS PATIENTS WHO EXPERIENCED INAPPROPRIATE SHOCKS AND INAPPROPRIATE ANTI-TACHYCARDIA PACING WITH SOME PATIENTS ALSO HOSPITALIZED. THE INAPPROPRIATE THERAPY WAS DUE TO DEVICE DETECTION ISSUES, NOISE/OVERSENSING, MYOPOTENTIAL OVERSENSING, OR LEAD MALFUNCTIONS. THE STATUS/DISPOSITION OF THE DEVICES AND LEADS IS UNKNOWN. NO FURTHER PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT. FURTHER FOLLOW UP DID NOT YET YIELD ANY ADDITIONAL INFORMATION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1859896 MEDTRONIC ICD IMPLANTABLE PACEMAKER PULSE-GENERATOR DXY MEDTRONIC, INC. MDT-ICD

Patients

Seq Age Sex Outcome Treatment
1 60 YR Male Hospitalization| L UNKNOWN COMPETITOR LEADS