FDA Adverse Event Death Summary report: N

SPRINT QUATTRO SECURE

MDR report key: 1813591 · Received August 25, 2010

Report

Report Number
2649622-2010-08878
Event Type
Death
Date Received
August 25, 2010
Date of Event
June 13, 2008
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
LWS
PMA / PMN Number
P920015/S24
Removal / Correction Number
ASKU
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MN, US
Reporter Occupation
PHYSICIAN

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. EVALUATION SUMMARY: (B)(4) NO ANOMALIES FOUND, THE PROXIMAL CONDUCTOR WAS DISTORTED, ALL CONDUCTORS HAD BLOOD/BODY FLUID (NOT OBSTRUCTED) PRESENT, OUTER INSULATION WAS MELTED, THE OUTER INSULATION WAS BREACHED/CUT, AND THE LEAD EXHIBITED APPARENT EXPLANT DAMAGE. THE FULL LEAD WAS RETURNED AND ANALYZED. PARTIAL LEAD IN SEGMENTS RETURNED AND ANALYZED. BLOOD IN/ON HELIX/LOBE MECHANISM (SLEEVE HEAD). FULL LEAD RETURNED AND ANALYZED. AT THE TIME OF THE RETRO REVIEW, IT WAS NOTED IN THE MANUFACTURER'S DATABASE THAT THE PATIENT HAD DIED. THERE IS NO ALLEGATION FROM A HEALTH CARE PROFESSIONAL THAT THE DEATH WAS DEVICE RELATED.

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. AT THE TIME OF THE RETRO REVIEW, IT WAS NOTED IN THE MANUFACTURER'S DATABASE THAT THE PATIENT HAD DIED. THERE IS NO ALLEGATION FROM A HEALTH CARE PROFESSIONAL THAT THE DEATH WAS DEVICE RELATED. EVALUATION SUMMARY: (B)(4) NO ANOMALIES FOUND, THE PROXIMAL CONDUCTOR WAS DISTORTED, ALL CONDUCTORS HAD BLOOD/BODY FLUID (NOT OBSTRUCTED) PRESENT, OUTER INSULATION WAS MELTED, THE OUTER INSULATION WAS BREACHED/CUT, AND THE LEAD EXHIBITED APPARENT EXPLANT DAMAGE. THE FULL LEAD LEAD WAS RETURNED AND ANALYZED. (B)(4) NO ANOMALIES FOUND. (B)(4) NO ANOMALIES FOUND. PARTIAL LEAD IN SEGMENTS RETURNED AND ANALYZED. (B)(4) NO ANOMALIES FOUND, BLOOD IN/ON HELIX/LOBE MECHANISM (SLEEVE HEAD). FULL LEAD RETURNED AND ANALYZED. CORRECTION - DEVICE CONCLUSION CODE ON SN (B)(4) .

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4) NO ANOMALIES FOUND, THE PROXIMAL CONDUCTOR WAS DISTORTED, ALL CONDUCTORS HAD BLOOD/BODY FLUID (NOT OBSTRUCTED) PRESENT, OUTER INSULATION WAS MELTED, THE OUTER INSULATION WAS BREACHED/CUT, AND THE LEAD EXHIBITED APPARENT EXPLANT DAMAGE. THE FULL LEAD WAS RETURNED AND ANALYZED. (B)(4) NO ANOMALIES FOUND. (B)(4) NO ANOMALIES FOUND. PARTIAL LEAD IN SEGMENTS RETURNED AND ANALYZED. (B)(4) NO ANOMALIES FOUND, BLOOD IN/ON HELIX/LOBE MECHANISM (SLEEVE HEAD). FULL LEAD RETURNED AND ANALYZED. AT THE TIME OF THE RETRO REVIEW, IT WAS NOTED IN THE MANUFACTURER'S DATABASE THAT THE PATIENT HAD DIED. THERE IS NO ALLEGATION FROM A HEALTH CARE PROFESSIONAL THAT THE DEATH WAS DEVICE RELATED. THE CAUSE OF DEATH HAS BEEN REQUESTED AND NOT RECEIVED.

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

IT WAS REPORTED THAT THE PATIENT HOSPITALIZED FOR INFECTION ON (B)(6)2008 AND THE ENTIRE SYSTEM WAS EXPLANTED AND NOT REPLACED ON (B)(6)2008. IT WAS FURTHER NOTED THAT THE LEFT VENTRICULAR LEAD HAD DISLODGED AND HAD UNACCEPTABLE THRESHOLDS PRIOR TO BEING EXPLANTED FOR INFECTION. LATER REVIEW OF MANUFACTURER'S DATABASE REVEALED THE PATIENT EXPIRED. FOLLOW UP NOTED THE PATIENT WAS FOUND DOWN AT HOME AND WHEN EMS ARRIVED, PATIENT WITHOUT PULSE OR RESPIRATIONS. CAUSE OF DEATH WAS REPORTED TO BE CARDIAC ARREST.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HOSPITALIZED ON (B)(6) 2008 AFTER A FALL AT WHICH TIME ELEVATED TROPONIN LEVELS WERE FOUND WITH A DIAGNOSIS OF MYOCARDIAL INFARCTION. ON (B)(6) 2008 THE PATIENT WAS ALSO DIAGNOSED WITH ENDOCARDITIS AND HAD POSITIVE BLOOD CULTURES. AN ECHOCARDIAGRAM SHOWED NO VEGETATION ON DEVICE LEADS. THE ENTIRE SYSTEM WAS EXPLANTED AND NOT REPLACED ON (B)(6) 2008. IT WAS FURTHER NOTED THAT THE LEFT VENTICULAR LEAD HAD DISLODGED AND HAD UNACCEPTABLE THRESHOLDS PRIOR TO BEING EXPLANTED FOR INFECTION. THE PATIENT CONTINUED ANTIBIOTIC THERARPY AND WAS RELEASED FROM HOSPITAL. THE PATIENT WAS FOUND ON (B)(6) 2008. EMS ARRIVED AND ADMINISTERED MULTIPLE EXTERNAL SHOCKS FOR RHYTHMS OF VENTRICULAR FIBRILLATION. THE ICD/PACEMAKER DEVICE WAS NO LONGER IN PATIENT AND HAD BEEN REMOVED FOR ONE MONTH AT THE TIME OF DEATH. CAUSE OF DEATH WAS REPORTED TO BE CARDIAC ARREST.

Description of Event or Problem · 1

IT WAS REPORTED PATIENT HOSPITALIZED ON (B)(6) 2008 AFTER FALL WHEN ELEVATED TROPONIN LEVELS WERE FOUND WITH DIAGNOSIS OF MYOCARDIAL INFARCTION. ON (B)(6) 2008 PATIENT DIAGNOSED WITH ENDOCARDITIS WITH POSITIVE BLOOD CULTURES. ECHOCARDIAGRAM SHOWED NO VEGETATION ON LEADS. ENTIRE SYSTEM EXPLANTED AND NOT REPLACED ON (B)(6) 2008. FURTHER NOTED LEFT VENTICULAR LEAD DISLODGED AND HAD UNACCEPTABLE THRESHOLDS PRIOR TO EXPLANT FOR INFECTION. PATIENT CONTINUED ANTIBIOTIC THERARPY AND RELEASED FROM HOSPITAL. PATIENT WAS FOUND DOWN ON (B)(6) 2008. EMS ARRIVED AND ADMINISTERED MULTIPLE EXTERNAL SHOCKS FOR RHYTHMS OF VENTRICULAR FIBRILLATION. DEVICE WAS NO LONGER IN PATIENT AS HAD BEEN REMOVED ONE MONTH PRIOR. CAUSE OF DEATH WAS REPORTED TO BE CARDIAC ARREST. LATER REPORTED RV LEAD PACING THRESHOLD HAD ALSO INCREASED SUBSTANTIALLY AT 3 MONTHS AFTER IMPLANT, BUT PATIENT WAS "SO BORDERLINE AND PRECARIOUS," AND SINCE THE LEAD WAS WORKING, LEAD NOT REVISED AT THAT TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PATIENT HAD AN INFECTION AND THE ENTIRE SYSTEM WAS EXPLANTED AND NOT REPLACED. IT WAS FURTHER NOTED THAT THE LEFT VENTICULAR LEAD HAD DISLODGED AND HAD UNACCEPTABLE THRESHOLDS PRIOR TO BEING EXPLANTED. LATER REVIEW OF MANUFACTURER'S DATABASE REVEALED THE PATIENT EXPIRED. THERE IS NO ALLEGATION FROM A HEALTH CARE PROFESSIONAL THAT THE DEATH WAS DEVICE RELATED. THE CAUSE OF DEATH HAS BEEN REQUESTED AND NOT RECEIVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SPRINT QUATTRO SECURE ASKU LWS MEDTRONIC PUERTO RICO, INC. 6947 ASKU

Patients

Seq Age Sex Outcome Treatment
1 68 YR Death| H| L| R