FDA Adverse Event
Injury
Summary report: N
ISOLINE 2CR AND ISOLINE 2CT LEADS
MDR report key: 17977214
·
Received October 19, 2023
Report
- Report Number
- MW5147194
- Event Type
- Injury
- Date Received
- October 19, 2023
- Report Date
- October 4, 2023
- Manufacturer
- MICROPORT CRM USA INC.
- Product Code
- MRM
- Adverse Event
- Yes
- Report Source
- Voluntary report
- Reporter Location
- MA, US
- Reporter Occupation
- OTHER
- Health Professional
- *
Narratives
Description of Event or Problem · 0
IT WAS REPORTED THAT THIS RIGHT ATRIAL (RA) LEAD WAS EXPLANTED DUE TO A NON PRODUCT EXPERIENCE. A NEW DEVICE WAS IMPLANTED. NO ADDITIONAL 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 |
|---|---|---|---|---|---|---|---|
| 1579139 | ISOLINE 2CR AND ISOLINE 2CT LEADS | DEFIBRILLATOR, IMPLANTABLE, DUAL-CHAMBER | MRM | MICROPORT CRM USA INC. | 48RJB |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Unknown |