FDA Adverse Event Malfunction Summary report: N

FINELINE II EZ STEROX

MDR report key: 15306499 · Received August 26, 2022

Report

Report Number
2124215-2022-32824
Event Type
Malfunction
Date Received
August 26, 2022
Date of Event
August 24, 2022
Report Date
September 1, 2022
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
DTB
PMA / PMN Number
P960004/S014
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CH
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS INVESTIGATION IS COMPLETE. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE THIS INVESTIGATION WILL BE UPDATED.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING FILED TO UPDATE THE PATIENT IDENTIFIER.

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING FILED TO UPDATE THE PATIENT IDENTIFIER.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING THE IMPLANT THIS RIGHT ATRIAL (RA) LEAD DID NOT PACE AND HIGH PACING THRESHOLDS WERE SEEN. THE LEAD WAS REPOSITIONED BUT THE OBSERVATIONS DID NOT CHANGE THUS A NEW LEAD WAS USED. THE LEAD WAS SURGICALLY ABANDONED AND A NEW LEAD WAS USED. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING THE IMPLANT THIS RIGHT ATRIAL (RA) LEAD DID NOT PACE AND HIGH PACING THRESHOLDS WERE SEEN. THE LEAD WAS REPOSITIONED BUT THE OBSERVATIONS DID NOT CHANGE THUS A NEW LEAD WAS USED. THE LEAD WAS SURGICALLY ABANDONED AND A NEW LEAD WAS USED. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Description of Event or Problem · 0

IT WAS REPORTED THAT DURING THE IMPLANT THIS RIGHT ATRIAL (RA) LEAD DID NOT PACE AND HIGH PACING THRESHOLDS WERE SEEN. THE LEAD WAS REPOSITIONED BUT THE OBSERVATIONS DID NOT CHANGE THUS A NEW LEAD WAS USED. THE LEAD WAS SURGICALLY ABANDONED AND A NEW LEAD WAS USED. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2088963 FINELINE II EZ STEROX PERMANENT PACEMAKER ELECTRODE DTB BOSTON SCIENTIFIC CORPORATION 4471 581111

Patients

Seq Age Sex Outcome Treatment
1 49 YR Male