FDA Adverse Event
Malfunction
Summary report: N
RV LEAD
MDR report key: 17712878
·
Received September 7, 2023
Report
- Report Number
- MW5145402
- Event Type
- Malfunction
- Date Received
- September 7, 2023
- Report Date
- July 26, 2023
- Manufacturer
- SORIN CRM SAS
- Product Code
- NVN
- Product Problem
- Yes
- Report Source
- Voluntary report
- Reporter Location
- MA, US
- Reporter Occupation
- UNKNOWN
- Health Professional
- *
Narratives
Description of Event or Problem · 0
IT WAS REPORTED THAT THIS RIGHT VENTRICULAR (RV) LEAD EXHIBITED A GRADUAL RISE IN PACING IMPEDANCE AT AN IMPEDANCE OF 1100 OHMS. THE LEAD REMAINS IN USE. NO ADVERSE PATIENT EFFECTS WERE REPORTED. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 143715 | RV LEAD | DRUG ELUTING PERMANENT RIGHT VENTRICULAR (RV) OR RIGHT ATRIAL (RA) PACEMAKER ELE | NVN | SORIN CRM SAS | R53 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |