FDA Adverse Event Injury Summary report: N

REGENCY SC+

MDR report key: 1896454 · Received November 10, 2010

Report

Report Number
2017865-2010-05246
Event Type
Injury
Date Received
November 10, 2010
Date of Event
July 5, 2010
Manufacturer
ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION
Product Code
DXY
PMA / PMN Number
P880006
Removal / Correction Number
NA
Adverse Event
Yes
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 POST IMPLANT, THE PULSE GENERATOR SOMETIMES PACED AT THE PROGRAMMED RATE OF 60 PULSES PER MINUTE (PPM), AND SOMETIMES PACED AT 40 PPM. THE DEVICE WAS RECONNECTED TO THE LEADS, BUT THE SAME BEHAVIOR CONTINUED. THE DEVICE WAS EXPLANTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 REGENCY SC+ IMPLANTABLE PACEMAKER PULSE GENERATOR DXY ST JUDE MEDICAL CARDIAC RHYTHM MANAGEMENT DIVISION 2402L NA

Patients

Seq Age Sex Outcome Treatment
1 74 YR Required Intervention