FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 1851878 · Received October 4, 2010

Report

Report Number
2124215-2010-14193
Event Type
Injury
Date Received
October 4, 2010
Date of Event
July 9, 2010
Report Date
July 9, 2010
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
PMA / PMN Number
P960004
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

ALL AVAILABLE INFORMATION INDICATES THAT THE PRODUCT REMAINS IN SERVICE. THERE IS NO ADDITIONAL INFORMATION AVAILABLE. IF ADDITIONAL INFORMATION BECOMES AVAILABLE, THE EVENT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THE PATIENT WITH THIS CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D) SYSTEM HAD AN INFECTION. NO ADVERSE PATIENT EFFECTS HAVE BEEN REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4469

Patients

Seq Age Sex Outcome Treatment
1 86 YR Other 6744| 0148| H170| H135| 4047| 4469