FDA Adverse Event Summary report: N

CARDIAC PACEMAKERS, INC.

MDR report key: 132452 · Received November 11, 1997

Report

Report Number
132452
Date Received
November 11, 1997
Report Date
October 29, 1997
Manufacturer
CARDIAC PACEMAKERS, INC.
Product Code
LWS
Report Source
User Facility report
Reporter Location
IL, US
Reporter Occupation
NURSE

Narratives

Description of Event or Problem · 1

PT HAD AN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR GENERATOR CHANGE 10/17/97 (THE ICD WAS ORIGINALLY IMPLANTED 10/5/93-A LEAD AND A SQ PATCH WERE ALSO IMPLANTED IN 1993). FOLLOWING SURGERY A LARGE HEMATOMA DEVELOPED AND THERE WAS BLEEDING FROM THE INCISION. A HEMATOMA EVACUATION WAS PERFORMED 10/22/97. AT THIS TIME THE WIRES IN THE SQ PATCH WERE FOUND TO BE BROKEN. IT IS UNKNOWN WHEN THIS OCCURRED (SOMETIME SINCE '93 AT THE GENERATOR CHANGE 10/17/97; OR DURING THE HEMATOMA EVACUATION 10/22/97). THE PATCH WAS CAPPED AND THE SYSTEM WAS RECONFIGURED USING THE EXISTING LEADS WITH SUCCESS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CARDIAC PACEMAKERS, INC. Implant SQ PATCH LWS CARDIAC PACEMAKERS, INC. 0063 *

Patients

Seq Age Sex Outcome Treatment
1 *