FDA Adverse Event Death Summary report: N

FINELINE II

MDR report key: 1674432 · Received May 4, 2010

Report

Report Number
2124215-2010-09413
Event Type
Death
Date Received
May 4, 2010
Date of Event
April 8, 2010
Report Date
April 8, 2010
Manufacturer
CPI - DEL CARIBE
Product Code
DTB
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
PATIENT

Narratives

Additional Manufacturer Narrative · 1

THIS PRODUCT HAS NOT BEEN RETURNED. NO ADDITIONAL INFO IS AVAILABLE AT THIS TIME. IF ADDITIONAL INFO BECOMES AVAILABLE, THIS EVENT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFO THAT THIS PT WAS ADMITTED TO THE HOSP POST DEVICE REPLACEMENT PROCEDURE WITH PNEUMONIA. IT WAS REPORTED THAT THE PT EXPIRED IN THE HOSP NINE DAYS POST REPLACEMENT PROCEDURE, DUE TO SEPSIS AND CARDIOPULMONARY ARREST. THE PHYSICIAN REPORTED THAT THE CAUSE OF DEATH WAS NOT DEVICE RELATED, AND THERE WAS NO INFECTION NOTED AT THE SURGICAL SITE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD DTB CPI - DEL CARIBE 4469

Patients

Seq Age Sex Outcome Treatment
1 77 YR Death 4456| S606| 4469| 1290