FDA Adverse Event Injury Summary report: N

ATTAIN ABILITY

MDR report key: 1921291 · Received December 13, 2010

Report

Report Number
2649622-2010-12440
Event Type
Injury
Date Received
December 13, 2010
Manufacturer
MEDTRONIC PUERTO RICO, INC.
Product Code
OJX
PMA / PMN Number
P080006
Removal / Correction Number
ASKU
Adverse Event
Yes
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE INFORMATION SUBMITTED REFLECTS ALL RELEVANT DATA RECEIVED. IF ADDITIONAL RELEVANT INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SUBMITTED. EVALUATION SUMMARY: (B)(4): THE FULL LEAD WAS RETURNED AND ANALYZED. PRIMARY ANALYSIS RESULTS REVEALED NO ANOMALIES. ANALYSIS ALSO REVEALED THAT THE CONDUCTORS WERE DISTORTED, BLOOD/BODY FLUIDS IN ALL THE CONDUCTORS (NOT OBSTRUCTED), AND APPARENT EXPLANT DAMAGE. (B)(4) ANALYSIS OF THE DEVICE FOUND A HIGH CURRENT DRAIN CONDITION. ELECTRICAL ANALYSIS REVEALED THE CAUSE OF THE HIGH CURRENT DRAIN WAS CURRENT LEAKAGE IN THE BATTERY FILTER CAPACITORS. THE DEVICE IS PART OF THE ADVISORY FOR THIS MODEL.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING THE IMPLANT ATTEMPT THE LEAD DISLODGED, THERE WERE UNACCEPTABLE THRESHOLDS AND OVERSENSING OBSERVED. THE PATIENT ANATOMY WAS TORTUOUS AND ATTEMPTS TO REVISE WERE UNSUCCESSFUL. THE LEAD WAS REMOVED AND REPLACED. IT WAS ALSO REPORTED THAT THE DEVICE REACHED ELECTIVE REPLACEMENT INDICATOR PREMATURELY. THE DEVICE WAS REMOVED AND REPLACED. NO PATIENT COMPLICATIONS HAVE BEEN REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ATTAIN ABILITY IMPLANTABLE PACING LEAD OJX MEDTRONIC PUERTO RICO, INC. 4196 ASKU

Patients

Seq Age Sex Outcome Treatment
1 65 YR Hospitalization| R 6949 IMPLANTABLE TACHY LEAD| 5076 IMPLANTABLE PACING LEAD