FDA Adverse Event Malfunction Summary report: N

CURRENT PLUS VR, DF-4 CONNECTOR

MDR report key: 1895776 · Received November 10, 2010

Report

Report Number
2017865-2010-04669
Event Type
Malfunction
Date Received
November 10, 2010
Date of Event
August 9, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
LWS
PMA / PMN Number
P910023
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED ANALYSIS FOUND THE DEVICE TO EXHIBIT HIGH IMPEDANCE. ADDITIONAL TESTING ON THE BENCH AND ON AUTOMATED ELECTRICAL SYSTEM AS WELL AS EXTENSIVE TEMPERATURE CYCLING FOUND NO ANOMALIES. A ROOT CAUSE FOR THE HIGH IMPEDANCE COULD NOT BE DETERMINED.

Description of Event or Problem · 1

THIS REPORT IS TO ADVISE OF AN EVENT OBSERVED DURING ANALYSIS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CURRENT PLUS VR, DF-4 CONNECTOR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LWS ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION CD1211-36Q NA

Patients

Seq Age Sex Outcome Treatment
1