BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DURATA STS OPTIM ACTIVE FIXATION

    MDR report key: 1895995 · Received November 10, 2010

    Report

    Report Number
    2017865-2010-04490
    Event Type
    Malfunction
    Date Received
    November 10, 2010
    Date of Event
    September 10, 2010
    Manufacturer
    ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
    Product Code
    NVY
    PMA / PMN Number
    P950022
    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.

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE SENSING THRESHOLD HAD DECREASED OVER TIME. THE PHYSICIAN ELECTED TO PERFORM AN INDUCTION TEST. ALL MEASUREMENTS WERE NORMAL, BUT THE SENSING THRESHOLD WAS STILL LOW. THE PHYSICIAN ELECTED TO LEAVE THE LEAD AS IS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 DURATA STS OPTIM ACTIVE FIXATION DEFIBRILLATION LEAD NVY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 7120/65 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR