FDA Adverse Event Injury Summary report: N

INGENIO

MDR report key: 18344824 · Received December 18, 2023

Report

Report Number
2124215-2023-71606
Event Type
Injury
Date Received
December 18, 2023
Date of Event
November 27, 2023
Report Date
August 27, 2024
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
LWP
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AR
Reporter Occupation
PHYSICIAN
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

THIS REPORT IS BEING FILED TO UPDATE THE PATIENT IDENTIFIER.

Additional Manufacturer Narrative · 0

THIS DEVICE WAS EXPECTED TO BE RETURNED. SHOULD THE DEVICE BE RETURNED ANALYSIS WILL BE CONDUCTED AND THIS INVESTIGATION WILL BE UPDATED.

Additional Manufacturer Narrative · 0

THIS CRT-P WAS THOROUGHLY INSPECTED AND ANALYZED UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY. THE DEVICE COULD NOT BE INTERROGATED AND WAS EXHIBITING NO PACING PULSES. THE DEVICE CASE WAS REMOVED TO FACILITATE INSPECTION AND TESTING OF THE INTERNAL COMPONENTS. THE BATTERY WAS REMOVED AND REPLACED WITH AN EXTERNAL POWER SOURCE. TESTING CONFIRMED A NORMAL CURRENT DRAIN. THE BATTERY WAS FORWARDED FOR DETAILED ANALYSIS AND WHILE THE BATTERY WAS CONFIRMED TO BE DEPLETED, THE ROOT CAUSE WAS UNABLE TO BE DETERMINED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD REPORTED TO THE HEALTH CARE PROFESSIONAL THAT THEIR PULSE RATE WAS FIFTY BEATS PER MINUTE. THE PATIENT WAS IN ARGENTINA ON HOLIDAY AND A RECENT CHECK SHOWED NEARING EXPLANT. THE HEALTHCARE PROFESSIONAL WAS GOING TO CONTACT THE PATIENT. TECHNICAL SERVICES (TS) DISCUSSED THAT PACING BELOW THE LOWER RATE LIMIT (LRL) CAN BE PRESENT BECAUSE OF MODIFIED - BASED TIMING AS WELL AS PREMATURE VENTRICULAR CONTRACTION (PVC) IDENTIFICATION. IN THIS CASE, THERE IS EVIDENCE OF NOISE OVERSENSING, LEADING TO THE DEVICE PACING BELOW THE LRL. ADDITIONAL INFORMATION WAS RECEIVED. THE DEVICE WAS FOUND TO BE IN SAFETY MODE AND THE PATIENT UNDERWENT URGENT DEVICE REPLACEMENT. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. THE DEVICE IS EXPECTED TO BE RETURNED FOR ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD REPORTED TO THE HEALTH CARE PROFESSIONAL THAT THEIR PULSE RATE WAS FIFTY BEATS PER MINUTE. THE PATIENT WAS IN ARGENTINA ON HOLIDAY AND A RECENT CHECK SHOWED NEARING EXPLANT. THE HEALTHCARE PROFESSIONAL WAS GOING TO CONTACT THE PATIENT. TECHNICAL SERVICES (TS) DISCUSSED THAT PACING BELOW THE LOWER RATE LIMIT (LRL) CAN BE PRESENT BECAUSE OF MODIFIED - BASED TIMING AS WELL AS PREMATURE VENTRICULAR CONTRACTION (PVC) IDENTIFICATION. IN THIS CASE, THERE IS EVIDENCE OF NOISE OVERSENSING, LEADING TO THE DEVICE PACING BELOW THE LRL. ADDITIONAL INFORMATION WAS RECEIVED. THE DEVICE WAS FOUND TO BE IN SAFETY MODE AND THE PATIENT UNDERWENT URGENT DEVICE REPLACEMENT. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. THE DEVICE IS EXPECTED TO BE RETURNED FOR ANALYSIS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE PATIENT HAD REPORTED TO THE HEALTH CARE PROFESSIONAL THAT THEIR PULSE RATE WAS FIFTY BEATS PER MINUTE. THE PATIENT WAS IN ARGENTINA ON HOLIDAY AND A RECENT CHECK SHOWED NEARING EXPLANT. THE HEALTHCARE PROFESSIONAL WAS GOING TO CONTACT THE PATIENT. TECHNICAL SERVICES (TS) DISCUSSED THAT PACING BELOW THE LOWER RATE LIMIT (LRL) CAN BE PRESENT BECAUSE OF MODIFIED - BASED TIMING AS WELL AS PREMATURE VENTRICULAR CONTRACTION (PVC) IDENTIFICATION. IN THIS CASE, THERE IS EVIDENCE OF NOISE OVERSENSING, LEADING TO THE DEVICE PACING BELOW THE LRL. ADDITIONAL INFORMATION WAS RECEIVED. THE DEVICE WAS FOUND TO BE IN SAFETY MODE AND THE PATIENT UNDERWENT URGENT DEVICE REPLACEMENT. NO ADDITIONAL ADVERSE PATIENT EFFECTS WERE REPORTED. THE DEVICE IS EXPECTED TO BE RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
67172 INGENIO IMPLANTABLE PULSE GENERATOR, PACEMAKER (NON-CRT) LWP BOSTON SCIENTIFIC CORPORATION J177 483092

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown Hospitalization| R