FDA Adverse Event Malfunction Summary report: N

VITALITY

MDR report key: 1871609 · Received October 15, 2010

Report

Report Number
2124215-2010-17437
Event Type
Malfunction
Date Received
October 15, 2010
Date of Event
August 30, 2010
Report Date
August 30, 2010
Manufacturer
GUIDANT CRM CLONMEL IRELAND
Product Code
LWS
Removal / Correction Number
Z-1192-06 THRU Z-1194-06
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A REVIEW OF DEVICE MEMORY REVEALED THAT THE DEVICE DECLARED END OF LIFE (EOL) AFTER EXPERIENCING ONE CHARGE TIME GREATER THAN 30 SECONDS. THE OBSERVED RATE OF BATTERY USAGE WAS COMPARED TO THE EXPECTED RATE OF BATTERY USAGE; THE RESULTS INDICATED THAT THE MONITORING VOLTAGE WAS NORMAL. ALTHOUGH THE BATTERY ITSELF HAD NOT DEPLETED PREMATURELY, EOL WAS TRIGGERED EARLIER THAN EXPECTED BY EXTENDED CHARGE TIMES DUE TO A HIGHER-THAN-TYPICAL BUILD-UP OF INTERNAL BATTERY IMPEDANCE. THIS ISSUE IS DISCUSSED IN THE Q3 2010 PRODUCT PERFORMANCE REPORT.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS DEVICE WAS EXPLANTED FOR NORMAL BATTERY DEPLETION. AT THE TIME OF EXPLANT, THERE WERE NO PRODUCT PERFORMANCE ALLEGATIONS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 VITALITY IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS GUIDANT CRM CLONMEL IRELAND T180

Patients

Seq Age Sex Outcome Treatment
1 66 YR 4086| E110| 0184| T180