FDA Adverse Event Injury Summary report: N

ALTRUA

MDR report key: 1862119 · Received October 8, 2010

Report

Report Number
2124215-2010-15734
Event Type
Injury
Date Received
October 8, 2010
Date of Event
July 29, 2010
Report Date
July 29, 2010
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
NVZ
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ACCORDING TO BOSTON SCIENTIFIC CRM RECORDS, THIS DEVICE IS STILL IN SERVICE. SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE, THIS EVENT WOULD BE UPDATED AS NECESSARY.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS PATIENT REPORTED THAT HER PACEMAKER STARTED ERODING AT THE POCKET SITE, THEREFORE THE PHYSICIAN MOVED THE DEVICE SUB PECTORAL. THE PATIENT WAS QUESTIONING IF THEY PUT IN A NEW DEVICE. OUR COMPANY'S RECORDS SHOW THIS DEVICE IS STILL IMPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ALTRUA IMPLANTABLE PULSE GENERATOR NVZ GUIDANT CRM CLONMEL IRELAND S603

Patients

Seq Age Sex Outcome Treatment
1 62 YR Required Intervention 4088| 4087| S603