FDA Adverse Event Injury Summary report: N

VIRTUOSO DR

MDR report key: 1862772 · Received October 9, 2010

Report

Report Number
6000144-2010-04981
Event Type
Injury
Date Received
October 9, 2010
Date of Event
July 13, 2010
Manufacturer
MEDTRONIC MED REL, INC.
Product Code
LWS
PMA / PMN Number
P980016/S062
Removal / Correction Number
Z-0128-2010
Report Source
Manufacturer report
Reporter Location
TN, 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. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL. EVALUATION SUMMARY: ANALYSIS OF THE DEVICE FOUND A HIGH CURRENT DRAIN CONDITION. ELECTRICAL ANALYSIS REVEALED THE CAUSE OF THE HIGH CURRENT DRAIN WAS CURRENT LEAKAGE IN THE BATTERY FILTER CAPACITORS.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BATTERY ON THE DEVICE DEPLETED IN 3.5 YEARS. THE DEVICE WAS REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VIRTUOSO DR IMPLANTABLE PACEMAKER/CARDIO/DEFIB LWS MEDTRONIC MED REL, INC. D154AWG ASKU

Patients

Seq Age Sex Outcome Treatment
1 57 YR Required Intervention 6949 IMPLANTABLE TACHY LEAD| 4076 IMPLANTABLE PACING LEAD