FDA Adverse Event Injury Summary report: N

FINELINE II

MDR report key: 1874752 · Received October 19, 2010

Report

Report Number
2124215-2010-17902
Event Type
Injury
Date Received
October 19, 2010
Date of Event
September 7, 2010
Report Date
September 7, 2010
Manufacturer
CPI - DEL CARIBE
Product Code
NVN
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

NO ADDITIONAL INFORMATION IS AVAILABLE AT THIS TIME. IF ADDITIONAL INFORMATION BECOMES AVAILABLE, THIS REPORT WILL BE UPDATED.

Description of Event or Problem · 1

BOSTON SCIENTIFIC CRM RECEIVED INFORMATION THAT THIS ATRIAL LEAD EXHIBITED IMPEDANCES GREATER THAN 2000 OHMS DUE TO A CONDUCTOR FRACTURE. IN A REVISION PROCEDURE, THE LEAD WAS SURGICALLY ABANDONED AND SUCCESSFULLY REPLACED BY A NEW LEAD. NO ADVERSE PATIENT EFFECTS WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FINELINE II IMPLANTABLE LEAD NVN CPI - DEL CARIBE 4470

Patients

Seq Age Sex Outcome Treatment
1 45 YR Required Intervention 4471| 4470| S603| 1290