FDA Adverse Event Malfunction Summary report: N

CONTAK RENEWAL 3 HE

MDR report key: 1874747 · Received October 19, 2010

Report

Report Number
2124215-2010-17807
Event Type
Malfunction
Date Received
October 19, 2010
Date of Event
September 6, 2010
Report Date
October 15, 2019
Manufacturer
BOSTON SCIENTIFIC CORPORATION
Product Code
NIK
PMA / PMN Number
P010012/S008
Removal / Correction Number
Z-0949-05 THRU Z-0953-05
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE FIELD REPRESENTATIVE LATER REPORTED THAT THE PATIENT'S EJECTION FRACTION HAD IMPROVED TO APPROXIMATELY 50% AND THE PATIENT AND PHYSICIAN WERE STILL DISCUSSING FUTURE OPTIONS. THE DEVICE REMAINS IMPLANTED.

Additional Manufacturer Narrative · 1

NO ADVERSE PATIENT EFFECTS WERE REPORTED. THE DEVICE REMAINS IMPLANTED. THIS REPORT WILL BE UPDATED WHEN ADDITIONAL INFORMATION IS RECEIVED.

Additional Manufacturer Narrative · 1

THE EXPLANTED DEVICE WAS RECEIVED AND IS UNDERGOING LABORATORY ANALYSIS. THIS REPORT WILL BE UPDATED WHEN ANALYSIS IS COMPLETE. UPON RECEIPT AT OUR POST MARKET QUALITY ASSURANCE LABORATORY, A THOROUGH EVALUATION OF THE DEVICE WAS PERFORMED. A VISUAL INSPECTION OF THE DEVICE HEADER AND CASE NOTED THE CASE WAS SWOLLEN; THE LV+ SEAL PLUG WAS DAMAGED AND THE RV+ SEAL PLUG WAS MISSING. THE SETSCREWS MOVED FREELY. THE DEVICE HAD NO TELEMETRY. THE DEVICE CASE WAS REMOVED AND AN EXTERNAL POWER SOURCE WAS ATTACHED FOR ADDITIONAL TESTING. MANUAL ELECTRICAL MEASUREMENTS NOTED NORMAL SENSING, PACING, AND DEFIBRILLATION FUNCTIONS. IT WAS NOTED THE ESTIMATED LONGEVITY FOR THIS MODEL DEVICE WAS 4.7 TO 5.0 YEARS, PER LABELING. THE DEVICE HAD BEEN IMPLANTED FOR 5.83 YEARS WHEN END OF LIFE (EOL) BATTERY STATUS WAS DECLARED EARLIER THAN EXPECTED (ONE MONTH AFTER ERI). HAVING MET THE ENGINEERING LONGEVITY PREDICTION, FUNCTIONALLY PASSED ALL RETURNED PRODUCT TESTING, AND WITH NO FURTHER INFORMATION TO INDICATE A PRODUCT PERFORMANCE ISSUE, WE HAVE CONCLUDED THAT THIS DEVICE EXPERIENCED NORMAL BATTERY DEPLETION.

Additional Manufacturer Narrative · 1

THE EXPLANTED DEVICE WAS RECEIVED AND IS UNDERGOING LABORATORY ANALYSIS. TIS REPORT WILL BE UPDATED WHEN ANALYSIS IS COMPLETE.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D) DECLARED END OF LIFE (EOL) BATTERY STATUS EARLIER THAN EXPECTED, WITH A MONITORING VOLTAGE OF 2.57V AND A CHARGE TIME OF 33.3 SECONDS. A RED ALERT WAS ISSUED IN LATITUDE FOR THIS BATTERY STATUS CHANGE. IT WAS NOTED THAT ELECTIVE REPLACEMENT INDICATOR (ERI) BATTERY STATUS HAD BEEN DECLARED THE PREVIOUS MONTH. TECHNICAL SERVICES DISCUSSED WITH THE PHYSICIAN THAT ALL BRADY PACING AND MAXIMUM ENERGY SHOCKS REMAINED AVAILABLE AT EOL. THE DEVICE WAS INCLUDED IN THE MID-LIFE DISPLAY OF REPLACEMENT INDICATORS ADVISORY AND APPEARED TO BE EXHIBITING THE ADVISORY BEHAVIOR.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D) DECLARED END OF LIFE (EOL) BATTERY STATUS EARLIER THAN EXPECTED, WITH A MONITORING VOLTAGE OF 2.57V AND A CHARGE TIME OF 33.3 SECONDS. A RED ALERT WAS ISSUED IN LATITUDE FOR THIS BATTERY STATUS CHANGE. IT WAS NOTED THAT ELECTIVE REPLACEMENT INDICATOR (ERI) BATTERY STATUS HAD BEEN DECLARED THE PREVIOUS MONTH. TECHNICAL SERVICES DISCUSSED WITH THE PHYSICIAN THAT ALL BRADY PACING AND MAXIMUM ENERGY SHOCKS REMAINED AVAILABLE AT EOL. THE DEVICE WAS INCLUDED IN THE MID-LIFE DISPLAY OF REPLACEMENT INDICATORS ADVISORY AND APPEARED TO BE EXHIBITING THE ADVISORY BEHAVIOR. THE FIELD REPRESENTATIVE LATER REPORTED THAT THE PATIENT'S EJECTION FRACTION HAD IMPROVED TO APPROXIMATELY 50% AND THE PATIENT AND PHYSICIAN WERE STILL DISCUSSING FUTURE OPTIONS. THE DEVICE REMAINS IMPLANTED. NINE YEARS LATER, THIS DEVICE WAS EXPLANTED AND REPLACED. THE NON-BOSTON SCIENTIFIC RIGHT VENTRICULAR (RV) LEAD WAS SURGICALLY ABANDONED FOR AN UNKNOWN PRODUCT PERFORMANCE ISSUE. THE PATIENT RECEIVED A NEW LEAD SYSTEM WITH THE NEW DEVICE (THERE WAS NOT PREVIOUSLY AN RA OR LV LEAD IMPLANTED). THERE WERE NO FURTHER ALLEGATIONS AGAINST THE DEVICE; IT IS SUSPECTED THE SYSTEM WAS ABANDONED ELECTRICALLY WHEN THE PATIENT'S CONDITION WAS IMPROVED IN 2010. LIKELY, THE PATIENT'S CONDITION DECLINED IN 2019, REQUIRING A NEW CRT-D. THE EXPLANTED DEVICE WAS RETURNED FOR ANALYSIS.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR (CRT-D) DECLARED END OF LIFE (EOL) BATTERY STATUS EARLIER THAN EXPECTED, WITH A MONITORING VOLTAGE OF 2.57V AND A CHARGE TIME OF 33.3 SECONDS. A RED ALERT WAS ISSUED IN LATITUDE FOR THIS BATTERY STATUS CHANGE. IT WAS NOTED THAT ELECTIVE REPLACEMENT INDICATOR (ERI) BATTERY STATUS HAD BEEN DECLARED THE PREVIOUS MONTH. TECHNICAL SERVICES DISCUSSED WITH THE PHYSICIAN THAT ALL BRADY PACING AND MAXIMUM ENERGY SHOCKS REMAINED AVAILABLE AT EOL. THE DEVICE WAS INCLUDED IN THE MID-LIFE DISPLAY OF REPLACEMENT INDICATORS ADVISORY AND APPEARED TO BE EXHIBITING THE ADVISORY BEHAVIOR. THE FIELD REPRESENTATIVE LATER REPORTED THAT THE PATIENT'S EJECTION FRACTION HAD IMPROVED TO APPROXIMATELY 50% AND THE PATIENT AND PHYSICIAN WERE STILL DISCUSSING FUTURE OPTIONS. THE DEVICE REMAINS IMPLANTED. NINE YEARS LATER, THIS DEVICE WAS EXPLANTED AND REPLACED. THE NON-BOSTON SCIENTIFIC RIGHT VENTRICULAR (RV) LEAD WAS SURGICALLY ABANDONED FOR AN UNKNOWN PRODUCT PERFORMANCE ISSUE. THE PATIENT RECEIVED A NEW LEAD SYSTEM WITH THE NEW DEVICE (THERE WAS NOT PREVIOUSLY AN RA OR LV LEAD IMPLANTED). THERE WERE NO FURTHER ALLEGATIONS AGAINST THE DEVICE; IT IS SUSPECTED THE SYSTEM WAS ABANDONED ELECTRICALLY WHEN THE PATIENT'S CONDITION WAS IMPROVED IN 2010. LIKELY, THE PATIENT'S CONDITION DECLINED IN 2019, REQUIRING A NEW CRT-D. THE EXPLANTED DEVICE WAS RETURNED FOR ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CONTAK RENEWAL 3 HE DEFIBRILLATOR, AUTOMATIC IMPLANTABLE CARDIOVERTER, WITH CRT-D NIK BOSTON SCIENTIFIC CORPORATION H177 502219

Patients

Seq Age Sex Outcome Treatment
1 48 YR 6949| H177