FDA Adverse Event Injury Summary report: N

QUADRA ASSURA MP¿

MDR report key: 16569640 · Received March 18, 2023

Report

Report Number
2017865-2023-13547
Event Type
Injury
Date Received
March 18, 2023
Report Date
March 17, 2023
Manufacturer
ST. JUDE MEDICAL, INC.(CRM-SYLMAR)
Product Code
NIK
UDI-DI
05414734508346
PMA / PMN Number
P030054
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Description of Event or Problem · 0

RELATED MANUFACTURER NUMBER: 2017865-2022-43255. IT WAS REPORTED 28 FEBRUARY, 2023 THAT ATRIAL UNDERSENSING RESULTING IN INAPPROPRIATE ATRIAL PACING WHICH IN TURN CAUSED VENTRICULAR PACING INTO REFRACTORY TISSUE WAS OBSERVED ON THE ATRIAL LEAD AND IMPLANTABLE CARDIOVERTER DEFIBRILLATOR. THE PATIENT WAS BEING MONITORED REMOTELY. FURTHER INFORMATION RECEIVED 12 MARCH, 2023 INDICATES THE PATIENT EXPERIENCED A VENTRICULAR TACHYCARDIA (VT) STORM AND ATTEMPTS TO PACE THE PATIENT OUT OF THE VT STORM WERE MADE. INTERROGATION REVEALED THE PATIENT WAS IN AND OUT OF VT FREQUENTLY BUT NOT IN VT AT THE TIME OF INTERROGATION. IT WAS NOTED THAT THE VT TYPICALLY FELL IN THE VT ZONE WHICH ONLY CONSISTED OF ANTI TACHYCARDIA PACING THERAPY (ATP) BUT THE PATIENT HAD RECEIVED SEVEN SHOCKS THAT MORNING. ISSUES WERE OBSERVED WITH TIMING CYCLE ACCURATELY DETECTING SLOW VT THAT RESULTED IN THE DEVICE DELIVERING SHOCK THERAPY BASED ON VENTRICULAR FIBRILLATION (VF) ZONE PARAMETERS THAT TEMPORARILY BROKE THE RHYTHM. THE PATIENT WAS NOTED TO BE IN ATRIAL FIBRILLATION (AF) THAT WAS BEING UNDERSENSED RESULTING IN INAPPROPRIATE PACING AND RESULTING IN PREMATURE VENTRICULAR CONTRACTIONS (PVCS) BEING BLANKED BY AN ATRIAL ALERT. THE PATIENT'S PROGRAMMED FACE RATE AND SLOW VT ALLOWED THIS OCCURRENCE. SEVERAL PROGRAMMING CHANGES WERE MADE TO ADDRESS THE OBSERVATIONS. THE PATIENT WAS VERY SICK DUE TO THEIR INTRINSIC CONDITION BUT NO STATEMENT WAS MADE INDICATING THEY WERE WORSE DUE TO THE SHOCK THERAPY RECEIVED. THE PATIENT WAS TO RECEIVE ADDITIONAL MEDICATION IN ATTEMPTS TO REDUCE THEIR VT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
939247 QUADRA ASSURA MP¿ IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST. JUDE MEDICAL, INC.(CRM-SYLMAR) CD3369-40C A000118255 05414734508346

Patients

Seq Age Sex Outcome Treatment
1 85 YR Male Required Intervention QUARTET| RIATA PASSIVE FIXATION