FDA Adverse Event Malfunction Summary report: N

SPRINT QUATTRO

MDR report key: 1791545 · Received August 10, 2010

Report

Report Number
2649622-2010-06937
Event Type
Malfunction
Date Received
August 10, 2010
Date of Event
June 29, 2010
Report Date
October 5, 2018
Manufacturer
MPRI
Product Code
LWS
PMA / PMN Number
P920015/S17
Removal / Correction Number
ASKU
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PREVIOUS EXPERIENCE FROM A RETRO REVIEW FOR DEVICES STILL IN USE HAS BEEN INCORPORATED INTO THIS REPORT.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. PREVIOUS EXPERIENCE FROM A RETRO REVIEW FOR DEVICES STILL IN USE HAS BEEN INCORPORATED INTO THIS REPORT. EVALUATION SUMMARY: (B)(4): THE ACTUAL LEAD WAS NOT RECEIVED FOR EVALUATION. WE DID RECEIVE PERFORMANCE DATA COLLECTED FROM THE DEVICE AND HAVE ANALYZED THE DATA. 4 - PATIENT ALERTS FOR OUT OF TOLERANCE SUBTHRESHOLD LEAD IMPEDANCE BETWEEN (B)(6) 2008 AND (B)(6) 2009. WEEKLY PACE LEAD IMPEDANCE TREND DATA IN (B)(4) SHOWS HIGH IMPEDANCE OVER THE RANGE FOR MAX RV PACE = 2880 TO 3392 PEAK OHMS, BETWEEN (B)(6) 2009 AND (B)(6) 2011.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Additional Manufacturer Narrative · 1

IF INFORMATION IS PROVIDED IN THE FUTURE, A SUPPLEMENTAL REPORT WILL BE ISSUED.

Description of Event or Problem · 1

A CALL WAS RECEIVED THROUGH TECHNICAL SERVICES REPORTING IMPEDANCE VALUES OF > 3000 OHMS WERE NOTED. PREVIOUS EXPERIENCE ON THIS DEVICE INCLUDES INCREASING IMPEDANCES OVER TIME, FROM AN INITIAL BASELINE OF 600-700 OHMS. CAPTURE THRESHOLDS AND SENSING HAVE BEEN AFFECTED. IT WAS REPORTED THAT IMPEDANCES HAD RISEN FROM 600-700 RANGE TO 2208 OHMS IN THE PREVIOUS YEAR. CAPTURE AND SENSING WERE BOTH AFFECTED: CAPTURE THRESHOLD INCREASED AND SENSING [R-WAVES] WERE DIMINISHED. HIGH VOLTAGE LEAD IMPEDANCES WERE ALSO RISING. AT 11 MONTHS LATER IT WAS REPORTED THAT CHRONIC IMPEDANCE RISE WAS CONTINUING, WITH RECENT IMPEDANCES BETWEEN 2320 - 2608 OHMS, AND OVERSENSING WAS NOTED IN DEVICE RECORDINGS. IT WAS LATER REPORTED THAT IMPEDANCE IS GREATER THAN 3000 OHMS AND THAT THE PACING/SENSING SITUATION CONTINUES TO BE MONITORED. IT WAS FURTHER REPORTED THAT THERE WAS T-WAVE OVERSENSING. THE LEAD REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

A CALL WAS RECEIVED THROUGH TECHNICAL SERVICES REPORTING IMPEDANCE VALUES OF > 3000 OHMS WERE NOTED. PREVIOUS EXPERIENCE ON THIS DEVICE INCLUDES INCREASING IMPEDANCES OVER TIME, FROM AN INITIAL BASELINE OF 600-700 OHMS. CAPTURE THRESHOLDS AND SENSING HAVE BEEN AFFECTED. THE LEAD REMAINS IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS FURTHER REPORTED THAT THE PACE/SENSE PORTION OF THE LEAD WAS CAPPED AND REPLACED WITH NO REPORTED ALLEGATIONS. THE REMAINS OF THE LEAD IS STILL IN USE. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SPRINT QUATTRO DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER LWS MPRI 6944 ASKU

Patients

Seq Age Sex Outcome Treatment
1 65 YR Other (B)(4) IMPLANTABLE PACEMAKER/CARDIO/DEFIB| 5076 IMPLANTABLE PACING LEAD| 5076 IMPLANTABLE PACING LEAD| (B)(4) IMPLANTABLE PACEMAKER/CARDIO/DEFIB| (B)(4) IMPLANTABLE PACEMAKER/CARDIO/DEFIB| 5076 IMPLANTABLE PACING LEAD