FDA Adverse Event Injury Summary report: N

ACCENT DR RF

MDR report key: 1896355 · Received November 10, 2010

Report

Report Number
2017865-2010-05375
Event Type
Injury
Date Received
November 10, 2010
Date of Event
August 19, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DXY
PMA / PMN Number
NA
Removal / Correction Number
NA
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

ALL INFORMATION PROVIDED BY MANUFACTURER, NO MEDWATCH FORM WAS RECEIVED. FINAL ANALYSIS FOUND AN INTERNAL SHORT IN THE BATTERY. THIS WAS THE CAUSE OF THE REPORTED EXCESSIVE BATTERY DISCHARGE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PULSE GENERATOR EXHIBITED EXCESSIVE BATTERY DISCHARGE. THE DEVICE REACHED ELECTIVE REPLACEMENT INDICATOR ON (B)(6) 2010, WITH BATTERY VALUES OF 2.59 V AND 8 UA. ON (B)(6) 2009, THE BATTERY VOLTAGE WAS 2.85 V WITH AN ESTIMATED 3.2 TO 4.4 YEARS REMAINING LONGEVITY. THE PULSE GENERATOR WAS EXPLANTED AND REPLACED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ACCENT DR RF IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION PM2210 NA

Patients

Seq Age Sex Outcome Treatment
1 75 YR Required Intervention