FDA Adverse Event Injury Summary report: N

ENRHYTHM DR

MDR report key: 1803312 · Received August 17, 2010

Report

Report Number
2647346-2010-00476
Event Type
Injury
Date Received
August 17, 2010
Date of Event
October 1, 2009
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
DXY
PMA / PMN Number
P980035/S38
Removal / Correction Number
ASKU
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PATIENT

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.

Description of Event or Problem · 1

THE PATIENT REPORTED THAT 2 MONTHS AFTER IMPLANT, PATIENT STARTED FEELING PAIN IN LEGS. IT EVENTUALLY MOVED INTO ARMS. THE PATIENT HAS SEEN MEDICAL DOCTORS, CARDIOLOGIST, CHIROPRACTOR AND HAS HAD SEVERAL TESTS DONE TO DIAGNOSE THIS PAIN. THE PATIENT THINKS IT COULD BE THE PACEMAKER SINCE IT STARTED AFTER IMPLANT. THE PATIENT THINKS IT COULD POSSIBLY BE AN ALLERGIC REACTION TO THE DEVICE AS WELL. THE CARDIOLOGIST HAS RULED OUT THE PAIN BEING RELATED TO THE PACEMAKER IMPLANT. THE DEVICE IS STILL IN USE. NO PATIENT COMPLICATIONS WERE REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ENRHYTHM DR IMPLANTABLE PULSE GENERATOR DXY MEDTRONIC MED REL, INC. P1501DR ASKU

Patients

Seq Age Sex Outcome Treatment
1 75 YR Other 5076 (X2) IMPLANTABLE PACING LEADS