FDA Adverse Event Injury Summary report: N

ATLAS II HF CRT-D

MDR report key: 1895948 · Received November 10, 2010

Report

Report Number
2017865-2010-04790
Event Type
Injury
Date Received
November 10, 2010
Date of Event
September 16, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
NIK
PMA / PMN Number
P030054
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE PREMATURE BATTERY DEPLETION WAS CONFIRMED IN THE LABORATORY. A LONGEVITY ESTIMATION WAS PERFORMED AND FOUND TO BE WITHIN SPECIFICATION. HOWEVER, THE BATTERY VOLTAGE DROPPED FROM ERI TO EOL PREMATURELY. AN INTERNAL ANOMALY WAS FOUND WITHIN THE BATTERY THAT RESULTED IN THE PREMATURE DEPLETION.

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. DEVICE EVALUATION ANTICIPATED BUT NOT YET BEGUN.

Description of Event or Problem · 1

Description of Event or Problem · 1

IT WAS REPORTED THAT THE DEVICE EXHIBITED PREMATURE BATTERY DEPLETION. WHEN THE DEVICE WAS DEACTIVATED FOR EXPLANT, THE PATIENT WENT ASYSTOLIC DUE TO OVERSENSING. THE DEVICE WAS EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATLAS II HF CRT-D IMPLANTABLE CARDIOVERTER DEFIBRILLATOR NIK ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION V-365

Patients

Seq Age Sex Outcome Treatment
1 72 YR Required Intervention