FDA Adverse Event Malfunction Summary report: N

ATLAS II PLUS HF CRT-D

MDR report key: 1895873 · Received November 10, 2010

Report

Report Number
2017865-2010-04796
Event Type
Malfunction
Date Received
November 10, 2010
Date of Event
August 20, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NIK
PMA / PMN Number
P030054
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. (B)(4). FAILURE (EVENT) OBSERVED DURING ANALYSIS UPON INTERROGATION, NO COMMUNICATION COULD BE ESTABLISHED WITH THE DEVICE DUE TO A DEPLETED BATTERY. THE DEVICE WAS ANALYZED WITH A NEW BATTERY AND FOUND TO BE NORMAL. THE BATTERY WAS SENT OUT TO THE VENDOR FOR FURTHER EVALUATION, AND NO ANOMALY WAS DETECTED. THE CAUSE FOR THE PREMATURE BATTERY DEPLETION 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 ATLAS II PLUS HF CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-366 NA

Patients

Seq Age Sex Outcome Treatment
1